Introduction: Depending on study populations and diagnostic methods, the prevalence of fibroids ranges from 4.5% to 68.6%. In the reproductive age group, fibroids may become clinically apparent and can cause significant symptoms in approximately 25% of women. In India, the prevalence of fibroids is reported to be 37.65% in rural populations and 24% in urban populations. Fibroids are the leading indication for hysterectomy, accounting for 39% of all hysterectomies performed annually in the United States. Although many are detected incidentally on imaging in asymptomatic women, 20% to 50% of women are symptomatic and may wish to pursue treatment. Aim and Objective: To study effect of mifepristone (25 mg) in treatment of uterine leiomyoma in perimenopausal woman. A) To Study the Effect of Mifepristone (25mg) On Uterine Leiomyoma. B) To Evaluate Any Symptomatic Improvement of Menorrhagia and Dysmenorrhea. Material and methods: This study was done at department of gynecology at NMCH Sasaram, Bihar over a period of 2 years from Dec 2019 to Dec 2021. Taking into consideration a hypothesis that 25 mg of Mifepristone daily for 3 months will offer at least 20% reduction in myoma volume from baseline. Non pregnant perimenopausal women of 45-50 years of age having symptomatic myomas (single or multiple) diagnosed by pelvic usg, who wish to conserve their uterus will be enrolled for the study. Result: Before the start of treatment 24 subjects had severe dysmenorrhea, 66 subjects had moderate dysmenorrhea, and 10 subjects had mild dysmenorrhea, after 3 month of treatment only 17 subjects had moderate dysmenorrhea and 83 subjects had mild dysmenorrhea, after 6 month of treatment all 100 study subjects had mild dysmenorrhea. Before the start of treatment, nine subjects had severe pressure symptoms, 13 subjects had moderate pressure symptoms,and after 3 months of treatment, only 11 subjects had moderate pressure symptoms. After 6 months of treatment, 7 subjects had moderate pressure symptoms, with no severe pressure symptoms. Conclusions: After treatment with 25 mg of mifepristone, fibroid volume, pressure symptoms, menorrhagia, and dysmenorrhea improve significantly, and the Haematocrit value improves significantly. In the present study, it was observed that there was a significant decrease in mass effect after treatment with mifepristone.