AIM: This report represents a case of chylous leakage after endometrial carcinoma surgery, providing therapeutic insights into similar cases in future. CASE PRESENTATION: This report describes a case of chylous leakage after endometrial carcinoma surgery. A 67-year-old woman with a 25-year of menopause was admitted to the hospital due to vaginal bleeding that had persisted for 5 days. She was diagnosed with high-grade serous carcinoma with partial sarcomatoid changes. Subsequently, she received surgical treatment for a malignant endometrial carcinoma, and chylous leakage occurred afterwards. A series of treatments were administered, eventually achieving satisfactory control over the patient's condition. RESULTS: The patient was managed with a multidisciplinary approach, including conservative measures such as bowel rest, total parenteral nutrition, and octreotide to reduce chyle production. Despite initial conservative treatment, chylous leakage persisted, leading to the decision for surgical intervention. Post-surgery, the patient showed significant improvement, with cessation of chylous drainage, and she was eventually discharged with a plan for follow-up care. CONCLUSIONS: Chylous leakage after endometrial carcinoma surgery is a serious complication that requires timely diagnosis and comprehensive treatment. This case provides valuable therapeutic insights into treatment plans and ways to improve prognosis of patients grappling with the same condition.