Abstract: Objective To understand the health status and healthcare service demand of perimenopausal women in Guangdong Province so as to explore the mode and methods for implementing climacteric and senectitude healthcare. Method Using the method of stratified and cluster sampling and according to the geographical features of Guangdong Province, we selected 4 500 perimenopausal women aged 40-65 years from 5 relatively small cities (representatives of the urban areas) and 4 counties (representatives of the rural areas) for this survey. Results The average age of natural menopause was 48.6 years in this cohort of women, and was 48.9 years in women from the urban areas and 48.3 years in those from the rural areas. The total incidence of diseases was similar in the urban and rural areas (38.5% vs 39.5%), accounting for an incidence of 39% in the total subjects. The 6 most prevalent diseases were bone and joint disease (12.5%), hypertension (9.2%), myoma of the uterus (6.8%), gastric or duodenal ulcer (5.2%), cardiac disease (2.7%) and diabetes mellitus (2.2%). In bone and joint disease, knee joint disease and lumbar vertebrae disease were the commonest (34.3% vs 32.8%), and the incidence of bone fracture was 2.5%. Perimenopausal syndrome had a prevalence rate of 68.1%, and the most distressful symptoms were sleeplessness, muscular, bone and joint pain, fidgety, dizziness, of which 86.8% were mental symptoms and 86.0% body symptoms. Women(71.2%) with perimenopausal symptoms received no medical treatment, and only 20.5% had ever sought medical care in the department of obstetrics and gynecology, often taking traditional Chinese medicines (53.9%). Only 1.4% of the symptomatic women received hormone therapy, the rate varied from 1.0% in the rural areas to 1.8% in the urban areas. Conclusion Perimenopausal syndrome and its related diseases severely affect the physical and mental health of perimenopausal women, who demand extensive healthcare services.