OBJECTIVES: Midlife women's knowledge, positive attitudes and management toward menopause may improve the quality of peri and post-menopause life. This study was to identify correlations of the knowledge, attitude, symptoms and management toward menopause in middle-aged women. METHODS: We used a cross-sectional questionnaire study applying to 231 perimenopausal and menopausal women aged from 40 to 59 years old. The completed data of 189 perimenopausal and menopausal women were analyzed through t-test, ANOVA and pearson's correlation coefficient using the SPSS statistical programme. RESULTS: The menopausal women showed significantly higher physical symptoms than perimenopausal women. The menopausal women showed significantly higher psychosomatic symptom than perimenopausal women. There was a significant correlation between the menopausal attitude and management. CONCLUSION: This study suggests that the fundamental data of developing midlife women's symptom index (MSI) and providing menopause management could be a strategy to encourage successful menopausal transition in middle-aged women.