Background: The present study was conducted for assessing the role of estradiol gel for genitourinary symptoms in postmenopausal females. Materials & methods:Randomized controlled trial was conducted among 50 post-menopausal women attending Gynae OPD with genitourinary symptoms included postmenopausal women with vaginal atrophy who attended our menopause clinic during July 2023 - September 2023.Women were randomly assigned to the estradiol gel group or control group. Estradiol gel treatment group consisted of 2 mL of product applied intravaginally daily for 2 weeks, and then reduced to maintenance two doses per week for the next 6 weeks. Outcomes were observed in severity of vaginal dryness, percentage of vaginal superficial and parabasal cells, and vaginal pH at final assessment. Adverse events were also assessed.Data was collected and analyzed using SPSS software version 19. Results:Vaginal dryness, Dyspareunia, Itching and Dysuria were the common clinical symptoms observed in the present study. Dry vaginal mucosa, pallor of mucosa and fragility of mucosa were the common signs seen among patients. There was a significant improvement in the signs and symptoms among patients of the estradiol gel group at 7 days and subsequently at 14 days. Conclusion:Estradiol gel plays a significant role in relieving genitourinary symptoms in postmenopausal females.