Squamous differentiation in endometrial adenocarcinoma is common. Rarely, it may be complicated by peritoneal keratin granulomas. Keratin granulomas accompanied by viable adenocarcinoma cells are regarded as conventional metastatic foci. However, the significance of keratin granulomas without accompanying viable adenocarcinoma cells is difficult to ascertain. Only a small number of cases with significant follow up are documented in the literature. We present two cases of peritoneal keratin granulomas, review the literature and discuss the significance of these lesions.