Objective <p>To observe the effectiveness of acupuncture in treating perimenopausal syndrome (kidney Yin deficiency pattern) and the impact on serum levels of estradiol (E₂), luteinizing hormone (LH), and follicle-stimulating hormone (FSH).</p> Methods <p>Sixty patients with perimenopausal syndrome differentiated as the kidney Yin deficiency pattern were recruited according to the inclusion and exclusion criteria. The participants were allocated to an acupuncture or medication group using the random number table method according to their visit sequence, with 30 cases in each group. The acupuncture group received acupuncture treatment 3 times weekly. The medication group was administered Kun Tai capsules orally. The intervention lasted 12 weeks for both groups. Before and after the intervention, the menopause rating scale (MRS) score and serum E₂, LH, and FSH levels were compared.</p> Results <p>When the treatment was completed, the acupuncture group achieved a total effective rate of 93.3%, compared with 83.3% in the medication group, demonstrating a significant difference (<i>P</i>&lt;0.05). After the intervention, increased serum E₂ levels were observed in both groups (<i>P</i>&lt;0.05), and the acupuncture group was higher than the medication group (<i>P</i>&lt;0.05); the serum levels of FSH and LH dropped significantly in both groups (<i>P</i>&lt;0.05) and were lower in the acupuncture group than in the medication group (<i>P</i>&lt;0.05).</p> Conclusion <p>Both acupuncture and oral administration of Kun Tai capsules can regulate serum endocrine hormone levels in patients with perimenopausal syndrome of kidney Yin deficiency pattern, with acupuncture treatment being more effective than oral Kun Tai capsules.</p>