16 cases of metastatic cancer in the endocardium collected from 2,050 autopsy cases in Baptist Medical Center, Missouri, USA from 1961 to 1983 are reported. There were 484 malignant tumors and 68 metastatic cancers in the heart, in which 16 involved the endocardium comprising 0.8% of the total autopsies during the same period, 3.3% of the malignant tumors and 23.5% of the metastatic cancer in the heart. Primary sites of these 16 cases are as follows: malignant melanoma 6 cases, lung cancer 2, thyroid carcinoma 2, rectal cancer 2, breast, liver, kidney and skin 1 case each. Metastatic cancer in the endocardium is rare. Diagnosis is commonly made by occurrent findings during autopsy. The primary lesions, metastatic sites and pathological and clinical features are discussed.