Background <p>This study aims to determine the effect of motivational interviewing (MI), an effective communication technique, on healthy lifestyle behaviors and quality of life in menopausal women.</p> Methods <p>This is a randomized controlled empirical study. The study was conducted with a total of 136 women, including 68 for experimental group and 68 for control group. The data were collected using an introductory information form, the Health Promoting Lifestyle Profile II (HPLPL II) and the Menopause-Specific Quality of Life (MENQOL). Women in the experimental group received 6 sessions of motivational interviewing and 2 follow-up interviews in two family health centers (FHCs) from the researcher. No intervention was applied to women in the control group. The data were analyzed using number, percentage, mean, standard deviation, chi-square test, Bonferroni test, independent samples t test and repeated ANOVA.</p> Results <p>There was a statistically significant difference between the HPLPL II total scale and health responsibility, nutrition, spiritual development, interpersonal relationships, and stress management subscales pre-test, interim test and post-test mean scores of women in the experimental group, and their mean scores increased positively (<i>p</i> &lt; 0.001). In addition, a statistically significant difference was also found between their MENQOL vasomotor, psychosocial, physical and sexual domains pre-test, mid-test and post-test mean scores (<i>p</i> &lt; 0.05).</p> Conclusion <p>Motivational interviewing was found to be effective in increasing healthy lifestyle behaviors and quality of life in menopausal women.</p> Trial registration <p>Current Controlled Trials NCT06802458, 17/01/2025 (https//clinicaltrials.gov/study/NCT06802458), “Retrospectively registered”.</p>