Objective: The study was to explore the role of EFEMP1 protein in angiogenesis and its relationship with prognosis of cervical carcinoma. Methods: EFEMP1 expression was evaluated by immunohistochemistry. The microvascular density (MVD) was detected with CD34 staining, and VEGF mRNA expression was evaluated by hybridization in situ. The associations of EFEMP1 with clinicopathologic characteristics, MVD, VEGF mRNA and overall survival were studied. Results: EFEMP1 expression was positively correlated with MVD and VEGF mRNA, and its overexpression was found to be significantly associated with lymph node metastasis, vascular invasion and poor survival. Multivariate analysis showed that EFEMP1 overexpression was independently related to poor prognosis of cervical cancer. Conclusions: EFEMP1 promotes angiogenesis and associates with lymph node metastasis, vascular invasion and poor prognosis of cervical carcinoma. The current study shows that EFEMP1 may be a useful prognostic factor for patients with cervical carcinoma. © 2009 Elsevier Inc. All rights reserved.