Abstract： Objective： To observe the clinical effect of modified Wuzi Yanzong Pills combined with Guyin Decoction for vaginal dryness in perimenopausal women. Methods： A total of 94 cases of perimenopausal women with vaginal dryness were selected and divided into two groups according to the random number table method， with 47 cases in each group. The control group was given external application of Estrogen Ointment and oral administration of Estradiol Valerate Tablets，and the treatment group was additionally treated with modified Wuzi Yanzong Pills combined with Guyin Decoction based on the treatment of the control group. The clinical effects， adverse reactions， and recurrence rates were compared between the two groups. Before and after treatment， traditonal Chinese medicine (TCM) syndrome scores， scores of quality of life， and levels of sex hormones in serum including follicle stimulating hormone (FSH) and estrogen (E 2 ) were compared between the two groups. Results：The total effective rate was 93.48% in the treatment group，higher than that of 80.43% in the control group (P＜ 0.05). The recurrence rate was 4.65% in the treatment group，lower than that of 21.62% in the control group (P＜0.05). Before treatment，there was no significant difference being found in the comparison of TCM syndrome scores between the two groups (P＞0.05)；after treatment，TCM syndrome scores such as small amount of menstrual volume， vaginal dryness， dyspareunia， waist and knee tenderness， dizziness and tinnitus，vexation and sweating，dry mouth and dry throat in the two groups were decreased (P＜0.05)，and the scores in the treatment group were lower than those in the control group (P＜0.05). Before treatment，there was no significant difference being found in the comparison of scores of quality of life between the two groups (P＞0.05)；after treatment，the scores of quality of life such as vulvaginal dryness and tingling sensation，dyspareunia，vaginal health index and vaginal atrophy index in the two groups were increased (P＜0.05)，and the scores in the treatment group were higher than those in the control group (P＜0.05). Before treatment， there was no significant difference being found in the comparison of levels of FSH and E 2 in serum between the two groups (P＞0.05)；after treatment，the FSH levels in serum in the two groups were decreased (P＜0.05) and E 2 levels were increased (P＜0.05)；the FSH level in serum in the treatment group was lower than that in the control group (P＜0.05)，and E 2 level was higher than that in the control group (P＜0.05). Conclusion：The combination of Wuzi Yanzong Pills and Guyin Decoction has a significant clinical effect on the treatment of vaginal dryness in perimenopausal women，with a low recurrence rate.