Abstract: Objective To explore the symptoms and cognitive situation for perimenopausal women. Methods From July to November 2013, a questionnaire survey was conducted on 454 perimenopausal women in the department of gynaecology and physical examination center of the First Affiliated Hospital of Xinjiang Medical University. The characteristics of symptoms, knowledge awareness and treatment intention were compared between Han nationality and ethnic minorities, between different cultural degrees and between different economic levels. Chi-square test or Fisher's exact test was used for statistical analysis. Results In 454 cases of perimenopausal women, 403 cases (88.8%) experienced symptoms of perimenopause. The most common symptoms were irritability, hot flashes, insomnia, fatigue and headache. 51 cases (11.2%) were asymptomatic. In the degree of education above senior high school group and senior high school or below group, the proportion of knowing the reason of perimenopause was 47.1% (112/238) vs 22.2% (48/216). In the monthly income > RMB 2 000 group and that ≤ RMB 2 000 group, the proportion of knowing the reason of perimenopause was 38.4% (117/305) vs 28.9% (43/149). The proportion of knowing hormone replacement therapy (HRT) of the Han nationality group was higher than that of the minority [27.1% (91/336) vs 12.7% (15/118)]; that of the degree of education above senior high school group was higher than that of senior high school or below group [31.5% (75/238) vs 14.4% (31/216)]; that of monthly income > RMB 2 000 was higher than that of monthly income of ≤ RMB 2 000 [30.2% (92/305) vs 9.4% (14/149)]. The proportion of willing to accept HRT of the Han nationality was higher than that of the minority [32.4% (109/336) vs 20.3% (24/118)]; that of the monthly income > RMB 2 000 was higher than that of the monthly income ≤ RMB 2 000 [34.5% (100/305) vs 22.1% (33/149)]. Conclusions The follow-up, monitoring and popularization of related knowledge should be strengthened to improve the quality of life of postmenopausal women, especially for those with low degree of education and low income.