To explore the effect of Jiawei Qingxuan Jiangya Decoction on blood pressure variability and sex hormone levels in perimenopausal women with hypertension. A total of 400 perimenopausal female hypertensive patients admitted to the hospital from June 2019 to June 2020 were randomly divided into observation group and control group, with 200 cases in each group. The patients in the control group took orally benazepril hydrochloride tablets, and the observation group was added with Jiawei Qingxuan Jiangya Decoction on the basis of the control group. The course of treatment was 1 month. The clinical efficacy of the two groups and the 24h blood pressure variability (BPV) and sex hormone levels before and after treatment were compared. The total effective rate of the observation group was significantly higher than that of the control group (P<0.05); the 24h BPV of the two groups after treatment was significantly lower than that before the treatment, and the reduction in the observation group was greater (P<0.05); the serum estradiol in the observation group after treatment was significantly increased, and the level of follicle stimulating hormone was significantly reduced, and compared with the control group after treatment, the difference was statistically significant (P<0.05). Jiawei Qingxuan Jiangya Decoction for treating hypertension in perimenopausal women can effectively reduce blood pressure, improve short-term blood pressure variability, regulate sex hormone levels to a certain extent, and correct endocrine disorders. It is worthy of clinical promotion.