Hormone replacement therapy has become a controversial treatment for symptoms of menopause, leading many women and their physicians to search for safer, effective alternatives. Certain botanicals are known to contain phytoestrogenic activity, which may be helpful in alleviating menopausal symptoms. We report the results of a study using a combination botanical supplement to treat menopausal symptoms. Prospective pilot study. Family practice medical center, Phoenix metropolitan area. Eight (8) women with moderate vasomotor and somatic symptoms of menopause. Combination botanicals daily for 3 months. Modified Kupperman Index (KI), daily hot flashes severity, and overall quality of life (QoL) using the SF-36 index, which were collected at enrollment, during treatment, and at the end of treatment. Mean KI total symptoms decreased from 30.3 +/- 7.5 to 22.9 +/- 8.4 (95% CI, 25-34), p = 0.0028. Daily hot flashes decreased from 68.1 +/- 14.3 to 39.6 +/- 9.7 (95% CI, 38-46), p = 0.0003, and the overall QoL also improved at the end of treatment. This pilot study demonstrates the potential benefit of a combination botanical for improving moderate menopausal symptoms in women. The efficacy and role of combination botanicals for long-term use to reduce menopausal symptoms requires further exploration.