Abstract: Perimenopausal women are under multiple pressures from work, family and life, while their health are significant for individuals, families, and society. If not treated correctly and effectively, perimenopausal insomnia can easily lead to cardiovascular, endocrine, anxiety and depression and other physical and mental diseases. At present, estrogen, benzodiazepines and melatonin still have significant side effects, so new ideas and methods are urgently needed. As an important resource in China, traditional Chinese medicine (TCM) has significant therapeutic effects and advantages in treating insomnia during perimenopause. Therefore, the current research status of perimenopausal insomnia from multiple perspectives, including epidemiology, pathogenesis, modern medical therapies, and the understanding and clinical practice of TCM are discussed in this review, so that more researchers, administrators, front-line physicians and the general public can pay attention to the health of perimenopausal women.