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OBJECTIVE: This study aimed to develop and evaluate a culturally adapted, group-based eight-session cognitive behavioral therapy (CBT) program for perimenopausal/postmenopausal Korean women to reduce vasomotor symptoms (VMS) and improve psychological well-being and quality of life. METHOD: In a non-blinded, parallel-group randomized controlled trial, 50 postmenopausal women were randomly assigned to a group-based CBT intervention group or a wait-list control group. Assessments were conducted at baseline, post intervention and at 4-week follow-up. Primary outcomes were VMS frequency and distress assessed using the Hot Flush Rating Scale (HFRS) and daily interference measured by the Hot Flash Related Daily Interference Scale (HFRDIS). Secondary outcomes included menopause-specific quality of life assessed using the Menopause-Specific Quality of Life Questionnaire (MENQOL), anxiety and depressive symptoms measured by the Hospital Anxiety and Depression Scale, and sleep quality assessed using the Pittsburgh Sleep Quality Index (PSQI). RESULTS: Compared with the control group, the CBT group showed significant improvements in VMS frequency, distress and daily interference. Quality of life improved across all MENQOL domains. Anxiety decreased significantly with sustained effects at follow-up. Depressive symptoms did not change significantly, and sleep improvements were not sustained. CONCLUSIONS: Group-based CBT effectively reduced VMS and improved quality of life and anxiety, supporting its use as a safe non-hormonal intervention for perimenopausal/postmenopausal Korean women. Menopausal symptoms such as hot flashes and night sweats can affect women’s daily life and emotional health. This study tested an eight-session cognitive behavioral therapy (CBT) program designed specifically for Korean women after menopause. Fifty women took part in the study, with some receiving the CBT program and others waiting as a control group. Women who participated in CBT experienced fewer hot flashes, felt less bothered by their symptoms and reported better quality of life and lower anxiety. These results suggest that this culturally adapted CBT program can be a safe and effective non-hormonal treatment option for menopausal women.