We analyzed retrospectively the clinical outcome of 108 patients with endometrial carcinoma operated at the Department of Obstetrics and Gynecology of Düsseldorf University regarding the effect of additional intravaginal brachytherapy. In 67 patients, we only performed an intraoperative rinsing of the vagina with alcohol and sutured the cervical canal to prevent vaginal recurrences. 41 patients received additional intravaginal brachytherapy. We observed only two vaginal recurrences in the 108 patients. There was no major difference in survival for patients with versus without additional intravaginal brachytherapy. We reviewed published studies critically regarding the efficacy and complications of intravaginal brachytherapy in operated endometrial cancer. These studies indicate that additional intravaginal brachytherapy can lower the rate of vaginal recurrences and that patients with dedifferentiated tumors, deep myometrial invasion and higher FIGO-stages might benefit most of this treatment modality.