Abstract：Objective：To explore the relationship between different Chinese medicinesyndrome types and X-ray grades in perimenopausal female patients with knee osteoarthritis. Methods： A total of 216 perimenopausal female patients with knee osteoarthritis were selected and divided into 87 cases of liver and kidney insufficiency syndrome，48 cases of spleenkidney yang deficiency syndrome， 31 cases of cold- damp obstruction syndrome and 50 cases of blood stasis obstruction syndrome according to Chinese medicine syndrome types， and the relationship between different Chinese medicine classification and X-ray grades was analyzed and compared. Results：There was significant difference in the comparison of X-ray grades between the four groups of different syndromes(P＜0.05)，and the X-ray grades were mainly concentrated in Grade Two and Three，accounting for 36.11% and 41.20% respectively，followed by Grade One and Grade Four，accounting for 8.80% and 12.96% respectively，and the minimum is Grade 0，accounting for only 0.93%. Among the cases of Grade One X-ray，the most was cold-damp obstruction syndrome(51.61%)，and the least is blood stasis obstruction syndrome； among the cases of Grade Two X-ray，the most was spleen-kidney yang deficiency syndrome(47.92%)，and blood stasis obstruction syndrome was the least； among the cases of Grade Three X- ray， the most was blood stasis obstruction syndrome(68.00%)，and the least was cold-damp obstruction syndrome；among the cases of Grade Four X-ray，the most was blood stasis obstruction syndrome(22.00% )， and the least was cold- damp obstruction syndrome. In cases of Grades One，Two，Three and Four X-ray ，the distribution of each syndrome type is different，the differences being significant(P＜ 0.05). Conclusion ： There are some differences in X-ray grades of different Chinese medicine syndrome types in perimenopausal female with knee arthritis，which can provide reference for Chinese medicine syndrome differentiation and treatment.