Objective To investigate the relationship between tubal sterilization and endometrial hyperplasia and endometrial cancer. Methods The clinical data of 4 987 peoples with diagnostic curettage in Datong, Shanxi Province from January 2008 to January 2017 were retrospectively analyzed. According to the pathological type, 2 891 cases were in abnormal endometrium group (simple hyperplasia, complex hyperplasia, and atypical hyperplasia, endometrial cancer) (experimental group) and 2 096 cases were in normal endometrium group (proliferative endometrium, secretory endometrium, atrophic endometrium) (control group). The relationship between tubal sterilization and endometrial hyperplasia and endometrial cancer was analyzed. Results The proportion of age, education level, sterilization, duration of sterilization and menopausal years were significantly different between the two groups (χ2values were 36.47, 15.05, 33.11, 34.50, 5.19, all P< 0.05). There was no significant difference in the other variables (all P> 0.05). Multivariate Logistic regression analysis showed that age ≥60 years (OR= 5.64, 95 % CI 1.42-16.08, P=0.012), sterilization (OR= 4.76, 95 % CI 1.31-12.69, P = 0.015), duration of sterilization ≥10 years (OR= 15.58, 95 % CI 2.05-118.54, P= 0.008) were high risk factors for endometrial abnormalities. Conclusions Tubal sterilization is a risk factor for the development of endometrial hyperplasia and endometrial cancer.The postoperative patients should be strengthened anti-cancer census.