The onset of menopause is unique to every woman with varying symptoms which have implications on health and well-being. This study evaluated the perception, knowledge and beliefs about menopause and the prevalence of climacteric symptoms. The study was a cross-sectional survey of 280 menopausal women aged 45 years and older in the Accra Metropolis of the Greater Accra Region of Ghana. Data on socio-demographic characteristics, knowledge, beliefs and experience of menopausal symptoms were collected using a semi-structured questionnaire. Anthropometric data on weight, height, % body fat and MUAC were also taken. All data were analyzed using SPSS version 16.0 and presented as means and frequencies. Predictors of menopausal symptoms were determined by logistic regression. The mean age of onset of menopause was (48±2.9) years with 98.2% having some knowledge of the signs and symptoms of menopause. The most frequently reported menopausal symptoms by the women were: night sweats (83.2%), hot flashes (76.4%), mood swings (72.5%) and vaginal dryness (71.4%). The significant predictors for the occurrence of the most common symptoms reported were: age at onset of menstruation, age of start of menopause, body weight and % body fat. There was a decreased risk of experiencing symptoms such as night sweats, mood swings and vaginal dryness as age at menopause increased. Menopausal transition was determined by both vasomotor and urogenital symptoms. Counseling and support are needed to enable women manage the symptoms better. Most women have heard of and know what menopause is.