Background: Endometrial cancer is being diagnosed more often in Indian women, sometimes at younger ages than previously expected. Several reproductive, metabolic, and lifestyle factors influence its development, but the relative impact of these risks varies across populations. Recognising local patterns may improve early detection. Aim: To examine selected clinical and metabolic risk factors associated with endometrial cancer in women attending a tertiary hospital in Tamil Nadu. Methods: A cross-sectional study was conducted among 78 women evaluated at Government Mohan Kumaramangalam Medical College and Hospital, Salem, between January 2023 and December 2024. Information on menstrual history, parity, anthropometry, comorbidities, and metabolic markers was collected. Histopathology confirmed the diagnosis, and associations between risk factors and endometrial cancer were assessed. Results: Women with endometrial cancer more frequently reported prolonged menstrual irregularity, obesity, later menopause, nulliparity, and diabetes. Patterns of unopposed estrogen exposure and metabolic disturbance appeared prominent among affected participants. Conclusion: Risk profiles common in this region may help clinicians identify women who need earlier evaluation for possible endometrial pathology. Simple clinical cues and metabolic screening at primary contact points could support earlier referral.