Clara Adams-Ender was born in Willow Springs, North Carolina, on 11 July 1939, the fourth of ten children. She was raised on a tobacco farm in Wake County where her father was a sharecropper, and graduated from Fuquay Springs Consolidated High School at the age of sixteen. Adams-Ender then attended North Carolina A&T State University in Greensboro, North Carolina, where she participated in the famous Woolworth's sit-in that begin on February 1, 1960. She entered the army's student nurse program to help pay her final two years of nursing school, and upon her graduation in 1961 was commissioned as a second lieutenant in the Army Nurse Corps.
Adams-Ender attended the officer basic orientation course at Brooke Army Medical Center at Fort Sam Houston, Texas. She then served as a staff nurse at Fort Dix, New Jersey, from 1961 to 1963 and completed an intensive care nurse course at Fitzsimmons Army Medical Center in Denver, Colorado. In 1963 she was assigned to the 121st Evacuation Hospital in South Korea, and from 1964 to 1967 she attended and then instructed at the U.S. Army Medical Training Center at Fort Sam Houston, Texas. Adams-Ender then attended the University of Minnesota for two years, earning a master's degree in medical-surgical nursing. She married her childhood sweetheart, James Adams, but they divorced five years later.
Adams-Ender returned to nursing instruction at Walter Reed Army Institute of Nursing in Washington, D.C., in 1969, and three years later was appointed as its education coordinator. In 1974 she directed the Department of Nursing, U.S. Army Medical Activity, at Fort Meade, Maryland. In 1975 she attended the U.S. Army Command and General Staff College at Fort Leavenworth, Kansas, and upon her graduation in 1976 became the first woman and the first nurse to earn a master's degree in military arts and sciences from the school. She was assigned to the U.S. Army Health Services Command at Fort Sam Houston, Texas, where she inspected hospitals. From 1978 to 1981 Adams-Ender served as assistant chief and later chief of the Department of Nursing at the 97th General Hospital in Frankfurt, Germany. While there, she was promoted to colonel and met Heinz Ender, whom she married in 1981.
Adams-Ender next directed nurse recruiting at Fort Sheridan, Illinois, from 1981 to 1984, and attended the U.S. Army War College, becoming its first black nurse corps graduate in 1982. She then served as chief of the Department of Nursing at Walter Reed Army Medical Center for three years, the first African American to do so. In 1987 Adams-Ender was promoted to brigadier general and named chief of the Army Nurse Corps. She served in that position until 1991, when she was named commanding general at Fort Belvoir, Virginia, the first army nurse and African American woman ever to command a major army base. Adams-Ender retired from the army in 1993, and later started a management consulting firm.