Background – Fibroid is the commonest benign tumor of uterus and one of the important indication for hysterectomy . Medical management of fibroids in perimenopausal women are effective as myoma regress after menopause .Various drugs are available for medical management including mifepristone ,an antiprogestine. Objectives –to evaluate the effect of mifepristone on symptomatic myoma in perimenopausal women. Variables to evaluate efficacy – changes in fibroid and uterine volumes, heoglobin level, endometrial thickness, side effects. Design – prospective study Material and method – this was a prospective study done at Department of Obstetrics and Gynecology of Patna Medical College and Hospital, Patna from October 2017 to March 2019 (over a period of 18mths. A total 45women attending outdoor, who were diagnosed with uterine fibroids were selected according to the inclusion criteria. 10 mg mifepristone was given to perimenopausal women with symptomatic myoma for three month. Changes in fibroid and uterine volumes, hemoglobin level was compared pre and post treatment. Improvement in symptoms and side effects of mifepristone were noted. Result –Immediate reduction in amount of heavy bleeding were noted in 100%, and 38((84.44%) women become amenorrhoeic after treatment . Mean PBAC score was 80.36±71.96 initially and it was decreased by 70.22% after one month of treatment and significantly to 91.42% after completion of treatment. Volume of leiomyoma decreased by 26.45%.there is 2.3% rise in haemoglobin level noted after completion of treatment. The drug did not have major side effect. In follow up after 6 month ie after 3 month of completion of treatment 45% patients were asymptomatic and no further change in myoma volume were noted. Conclusion – Mifepristone can be useful in treating symptomatic myoma in premenopausal women.