BACKGROUND: Menopause is associated with significant physical, psychosocial, and emotional changes that can negatively affect women's quality of life (QoL). In response to this, psychological interventions like mindfulness-based interventions have shown promise in alleviating menopausal symptoms and improving psychological well-being. METHODS: A comprehensive randomized controlled trial was conducted from May to August 2024 at Damanhour University, Egypt. One hundred and twenty menopausal women were randomly assigned to either the intervention group (n = 60), which participated in seven mindfulness sessions, or the control group (n = 60), which received general health education. Pre and postintervention data were collected using the Menopause-Specific QoL questionnaire, the Depression Anxiety Stress Scale-21, and the Mindful Attention Awareness Scale. Independent samples t-tests were performed to compare groups, while paired t-tests assessed within-group changes post-intervention. Effect sizes were calculated using Cohen's d, ensuring a robust and reliable data analysis. RESULTS: The intervention group showed significant improvements across all domains of menopause-specific QoL, including vasomotor (d = 0.788, p <
0.01), psychosocial (d = 1.042, p <
0.01), physical (d = 0.809, p <
0.01), and sexual (d = 0.794, p <
0.01). Additionally, significant reductions were observed in anxiety (d = 1.221, p <
0.01), stress (d = 1.030, p <
0.01), and depression (d = 0.880, p <
0.01), along with a significant increase in mindfulness (d = 1.335, p <
0.01) postintervention. CONCLUSION: The MBIS significantly improved menopause-specific QoL and reduced anxiety, stress, and depression while enhancing mindfulness in menopausal women. These findings suggest that mindfulness-based interventions could be game changers in managing menopausal symptoms and improving overall psychological well-being, offering hope for a better QoL for menopausal women. CLINICAL RELEVANCE: The research will primarily impact healthcare providers working with menopausal women, particularly those offering psychological support or nonpharmacological treatments. It also impacts menopausal women themselves by providing evidence-based intervention options that could alleviate menopausal symptoms. Furthermore, researchers and policymakers focusing on women's health and mental well-being may use these findings to inform future studies and healthcare strategies. PATIENT OR PUBLIC CONTRIBUTION: Women from Damanhur University. TRIAL REGISTRATION: This trial was registered with the ClinicalTrials.gov database under the registration number NCT06421909.