Fascin expression has been associated with clinicopathological parameters and clinical outcome in many carcinomas. The aim of this study was to evaluate the prognostic impact of fascin expression in small intestinal carcinomas (SICs). We constructed tissue microarrays for evaluation of immunohistochemical expression of fascin in a total of 194 SICs. Fascin was expressed in 47 (24.2%) of the 194 SICs, and fascin expression showed an association with poorly and undifferentiated histology (p < 0.001) and lymphatic invasion (p = 0.019). No fascin expression was observed in tumour cells of metastatic lymph nodes in cases of SIC without fascin expression (p < 0.001). Patients with fascin expression showed significantly shorter overall survival compared to patients without expression (p = 0.001). In multivariate analysis, fascin expression was an independent prognostic factor in SIC patients (p = 0.043). Fascin expression showed significant correlation with lack of differentiation and lymphatic invasion, and may be a useful predictive marker for lymph node metastasis. Fascin expression in SICs showed an association with poor overall survival and was an independent poor prognostic factor.