Purpose of investigation: To review our management experience with uterine mixed mullerian tumors (MMTs) in order to eva­luate potential prognostic indicators, and assess the efficacy of various treatment modalities. Methods: A retrospective, clinicopathologic evaluation of 43 patients presenting for treatment of uterine MMTs between 1982 and 1992 was conducted. Diagnostic criteria for inclusion was the presence of both a malignant glandular or squamous epithelial component, and a homologous or heterologous stromal component Results: Overall 2- and 5-year cancer related Kaplan-Meier survival estimates with 95% confidence intervals were 44 (.28,.59) and 26% [.12,.39], respectively. Survivals were 83 [.62,.99] and 58% [.31,.85] when disease was confined to the uterus, and 22 [.03,.41] and 7% [.01,.20] when disease extended beyond the uterus. Clinical staging was often inaccurate, with 29% of clinical stage I or II disease being upstaged at laparotomy. A significant survival advantage was found in patients with stage I or II disease treated with surgery plus pelvic irradiation (p = 0.001), as compared to those treated with surgery alone. The prognosis after disease recurrence was poor, irrespective of secondary therapy, with a median survival of 11 months. Conclusions: A therapeutic advantage may be gained from postoperative pelvic irradiation in the treatment of surgical stage I or II uterine MMT.