Pure squamous cell carcinoma arising in the endometrium represents a rare entity, accounting for <1 % of all endometrial malignancies. Limited data about pathogenetics' and behaviours' features are available. Of consequence, there is no consensus about classification and different therapeutic option. Four cases of elderly patients (aged > 65 years) affected by pure squamous cell carcinoma of the endometrium are presented. Known risk factors for endometrial squamous metaplasia (i.e., pelvic inflammatory disease and cervical stenosis) were observed in two patients. Patients with a disease limited to the uterine corpus had favourable prognosis after surgery ± radiotherapy, while one patient with lymph nodes involvement and another who refused staging and/or adjuvant therapy had recurrent disease. Primary squamous cell carcinoma of the endometrium is rare and aggressive occurrence, characteristic of elderly patients. Radical surgery and adjuvant radiotherapy should be administered.