Objective Body mass index (BMI) has been found to be associated with perimenopausal symptoms. This study focused on the relationship between overall perimenopausal symptoms and obesity in Taiwanese women living in rural communities. Materials and Methods This study was cross-sectional and descriptive, and the subjects included 56 climacteric women from a rural community in southern Taiwan. Data were collected using the Perceived Perimenopausal Disturbances Scale and face-to-face interviews, and obesity was assessed by anthropometric measurements (height, weight, and waist circumference). Results The current analysis included 56 women 40–60 years of age (mean age = 47.11 years). Twenty-five percent of the women were obese (BMI ≥ 27 kg/m 2) and 39.3% presented with central obesity (waist circumference ≥ 80 cm). Based on the subscale for perimenopausal symptoms, we found that for postmenopausal women, a higher BMI and waist circumference were associated with more frequent urinary complaints and reproductive system symptoms. Conclusion Participants reported more frequent urinary problems when they were postmenopausal, and these problems were associated with a higher BMI. The findings suggest that clinical practitioners should consider developing strategies to reduce BMI in mid-life women.