The objective of this study is to determine the effect of progesterone antagonist, Mifepristone in perimenopausal women in decreasing the severity of symptoms like menorrhagia, dysmenorrhea, abdominal pain and urinary symptoms, in decreasing the fibroid volume and uterine volume, in improving the hemoglobin percentage, in increasing the endometrial thickness, to look for the side effects profile and to look for the effects which were present at the end of treatment persisted during post treatment follow up. It is a prospective and interventional study done among the perimenopausal women with symptomatic fibroid uterus who came to the Gynecological OPD in Gandhi Hospital, Secunderabad for a period of one and half year in a sample size of 50 patients. After taking a detailed menstrual history and calculating Pictorial Blood loss Assessment Chart (PBAC) score for menorrhagia and Visual Analogue Scale (VAS) score for dysmenorrhea and abdominal pain, baseline fibroid and uterine volumes, haemoglobin percentage and endometrial thickness were noted and endometrial biopsy was done when endometrial thickness crossed≥8mm. The drug mifepristone 25 mg was given orally for a period of 3 months.