Objective: The aim of this study was to compare oncologic outcomes between minimally invasive surgery (MIS) and open surgery in the treatment of endometrial cancer with high risk of recurrence. Methods: This retrospective study included patients with endometrial cancer with high risk factor who underwent primary surgery in two tertiary centers in Korea and Taiwan. Stage III-IVA endometrial cancer with grade 1-2 endometrioid type, stage I-IVA endometrial cancer with grade 3 endometrioid type or non-endometrioid type were considered as factors of high risk of recurrence. We conducted 1:1 propensity score matching between MIS and open surgery group to adjust the baseline characteristics. Oncologic outcomes were compared according to surgical approach. Results: A total of 284 patients were included after propensity score matching. Among them, 32 (11.3%) cases were patients with low grade endometrioid carcinoma with advanced stage, 109 (38.4%) patients were grade 3 endometrioid carcinoma, and 143 (50.3%) were patients with non-endometrioid carcinoma. Compared to patients who underwent open surgery, MIS did not show difference in disease-free survival (HR 1.09, 95% CI 0.67-1.77, P=0.717) and overall survival (HR 0.67, 95% CI 0.36-1.24, P=0.198). In multivariate analysis, non-endometrioid histology, tumor size, tumor in cytology, depth of invasion, and lympho-vascular space invasion were risk factors for recurrence. There was no association between surgical approach in either recurrence or mortality in subgroup analysis according to stage and histologic type. Conclusion: Minimally invasive surgery did not compromise survival outcomes for endometrial cancer with high risk of recurrence when compared to open surgery.