Objective To investigate the influence of perimenopausal estrogen levels on the occurrence of osteoporosis. Methods From January 2014 to January 2016, 106 cases of perimenopausal women in the Traditional Chinese Medicine Hospital of Shengzhou were selected in the study.According to the age, they were divided into two groups, with 53 cases in each group.The control group was aged from 45 to 50 years old.The observation group was 51 to 55 years old.The levels of serum estradiol (E2), β-collagen specific sequence (β-CTX), N-terminal osteocalcin (NMID), total type I collagen amino acid extended peptide (PINP) and bone mineral density (BMD) were compared between the two groups. Results The levels of E2[(31.56±10.33) ng/L]and BMD[(80.72±24.19) mg/cm3]in the observation group were significantly lower than those in the control group[(73.72±13.28) ng/L, (125.68±38.75) mg/cm3](t=18.24, 7.17, all P<0.05). The levels of β-CTX, NMID and PINP in the observation group were (0.29±0.04) ng/mL, (24.38±11.69) ng/mL, (47.66±16.88) μg/L, respectively, which were significantly higher than those in the control group[(0.17±0.01) ng/mL, (11.4±2.63) ng/mL, (26.79±14.42)μg/L], the differences were statistically significant (t=21.19, 8.04, 6.84, all P<0.05). Conclusion The level of perimenopausal hormone in women is related to the occurrence of osteoporosis.With the decrease of estrogen level, the incidence rate of osteoporosis is increased, which is of great reference value for the prevention, diagnosis and treatment of disease. Key words: Perimenopause; Osteoporosis; Estrogens