Purpose: This study compared climacteric symptoms, knowledge of menopause and menopausal management of middle aged women living in urban and rural areas. Method: The study subjects included 287 women aged 40-64 years in P city and G town. The instruments used in this study were a climacteric symptoms scale and knowledge of menopause and a menopausal management scale. Data was analyzed with SPSS Win 10.0. Result: The mean age of middle-aged women living in urban areas was 47.9 years and that of women in rural areas was 48.0 years. The mean score of the climacteric symptoms of middle-aged women living in urban and rural areas was 48.8 and 50.4 respectively, and was not significantly different. The mean score of the knowledge of menopause of middle-aged women living in urban areas was higher than that of women in rural areas (p=.017). In addition, the mean score of the menopausal management of middle-aged women living in rural areas was higher than that of women in urban areas. Conclusion: This study suggests that not only general characteristics but also living areas should be considered in developing nursing interventions to manage the climacteric symptoms of middle aged women.