Objective: To determine the prevalence and severity of menopausal symptoms and their related factors among Korean menopausal women according to their reproductive stages. Methods: This cross-sectional study included 3,039 Korean women aged 45-65 years who attended routine health check at a single institution. Their results in Menopause Rating Scale (MRS) were compared according to the menopausal period which was categorized into four groups including premenopause, early menopause (≤2 years from the last menstruation), mid-menopause (2-8 years), and late menopause (>8 years). Results: The mean age of the participants was 52.90 ± 5.39 years, and 94.9% of them reported one or more of the symptoms included in the MRS. The most common symptom was physical/mental exhaustion experienced by 86.5% of all participants. The prevalence of moderate-to-severe symptoms including vasomotor symptoms, heart discomfort, sleep problems, sexual problems, vaginal dryness, and joint/muscular discomfort increased at the early menopausal period, and those were still higher at late menopausal period compared to the level at the premenopausal period. The prevalence of moderate-to-severe psychological symptoms, heart discomfort, and sleep problems showed the trend of u-shaped pattern after menopause: high at early menopause, low at mid-menopause and high again at late menopausal period. Low physical exercise level was an independent risk factor for high total MRS score, while the menopausal stage, age, and overweight were also associated diversely with menopausal symptoms. Conclusion: Variable menopausal symptoms remain severe or are even aggravated until the late menopausal periods among the Korean women. More attention is warranted to manage those symptoms for elderly women.