Endometrial cancer is the most common malignancy of the female genital tract. It is typically a disease of postmenopausal women and often presents with postmenopausal vaginal bleeding. In 75% of cases, it is diagnosed at an early stage and is associated with better overall survival rates than many malignancies. The appropriate staging surgery for patients diagnosed with endometrial cancer is a total hysterectomy and bilateral salpingo-oophorectomy with pelvic and para-aortic lymphadenectomy. Adjuvant radiation therapy in early-stage disease is associated with decreased rates of locoregional recurrences but does not improve overall survival. The role of chemotherapy is not well established for early-stage disease. Treatment recommendations for locoregional recurrence of endometrial cancer after hysterectomy are poorly defined and include tumor-directed radiation therapy, and/or chemotherapy, and/or surgical resection. Because the current guidelines are not specific, they are confusing to clinicians. To illustrate this, this report presents a patient who was diagnosed with stage IA endometrial cancer and developed vaginal cuff recurrence 3 months after surgery.