Aim: The Aim of this study to evaluate the long-term sequelae of estrogen deprivation in women .and safety of ovarian preservation in young women with endometrial cancer who underwent hysterectomy. Methods: We include the women ≤ 50 years of age with stage I endometrial cancer recorded from 2022 to 2024.We prepared Cox proportional hazards models and Kaplan-Meier curves to compare women who underwent oophorectomy with those who had ovarian preservation. Results: A total of 3,200 women, including 400 patients (12%) who had ovarian preservation, were identified. Younger age (P < .0001), later year of diagnosis (P = .04), residence govt. medical college , gynaecology department (P = .02), and low tumor grade (P < .0001) were associated with ovarian preservation. In a multivariate Cox model, ovarian preservation had no effect on either cancer-specific (hazard ratio [HR] = 0.55; 94% CI, 0.12 to 2.40) or overall (HR = 0.68; 95% CI, 0.34 to 1.35) survival. Conclusion: Ovarian preservation in premenopausal women with early-stage endometrial cancer is safe and not associated with an increase in cancer-related mortality.