Background <p>Menopausal symptoms are common and can affect all aspects of women’s quality of life. While prior systematic reviews have explored menopausal symptoms and QoL, inconsistencies persist, particularly regarding symptom severity during the menopausal transition. This review synthesizes evidence to clarify this association. However, controversial findings have been reported on the association between menopausal symptoms and quality of life in post-menopausal women. Therefore, it was decided to conduct a systematic review to evaluate the relationship between the severity of menopausal symptoms and quality of life during the transition to menopause.</p> Methods <p>A systematic search was conducted in Web of Science, Scopus, PubMed, Magiran (a Persian database), and the Google Scholar search engine. Search strategy was designed using Menopause, Quality of life intensity, and menopausal symptoms in English and their Persian synonyms. Studies that evaluated the relationship between the severity of menopausal symptoms and quality of life in transition to menopause as the main or secondary objective were included in the study.</p> Results <p>From the 300 primary identified articles, 15 articles that met the inclusion criteria were selected for review. This systematic review found a positive relationship between the severity of menopausal symptoms and the quality of life in studies conducted in most regions. However, this relationship was negative in some areas.</p> Conclusions <p>The findings of this study can be used in interventions to improve the quality of life in menopausal women. These findings inform targeted interventions, such as symptom management programs, to enhance QoL in menopausal women globally.</p>