Objective To observe the expression changes of micro RNA-23a（miR?23a） and apoptotic protease-activating factor-1 （APAF-1） in endometrial carcinoma tissues and analyze its clinical significance. Methods 123 specimens of endometrial carcinoma in our hospital from May 2018 to May 2020 were selected as endometrial carcinoma group， and the para cancerous tissue was selected as the normal group. Expression of miR-23a and APAF-1 were examined in endometrial tissues； the relationship between miR-23a and APAF-1 and the clinicopathology of patients and the correlation between the two were analyzed； Kaplan-Meier method was used to analyze the survival of patients with endometrial cancer. Results Compared with the normal group， the expression level of miR-23a in endometrial carcinoma group was significantly increased， the expressions of APAF-1 mRNA and protein decreased significantly （P < 0.05）； miR-23a and APAF-1 were significantly correlated with clinical stage， histological differentiation and myometrial invasion （P < 0.05）； Pearson analysis showed that miR-23a was negatively correlated with APAF-1 （P < 0.05）； Kaplan-Meier curves showed that PFS and OS were significantly higher in the miR-23a low-expression group as well as the APAF-1-positive expression group than in the miR-23a high-expression group and the APAF-1-negative expression group（P < 0.05）. Conclusion The expression level of miR-23a is increased and APAF-1 expression is decreased in endometrial carcinoma， both of which correlate with endometrial cancer progression and patient prognosis， are expected to be biomarkers for clinical assessment of disease progression and prognosis in early-stage patients.