Introduction: Menopause is associated with a decline in estrogen levels that trigger a number of physical and physiological changes affecting quality of life. Objective: To assess the quality of life (QoL) and associated factors in postmenopausal women. Methods: A total of 245 post-menopausal women aged >40 years (75.1% aged 50 years or above, mean duration of menopause 5.90 years) were enrolled in the study after excluding those with chronic physical or psychological illnesses. Socio-demographic and clinical details were noted and QoL was assessed using MENQOL questionnaire. Data was analyzed using SPSS 25.0 software with help of Chi-square, ANOVA and Independent samples ‘t’-tests. Results: Symptom and psychosocial issue most severely affected were decrease in sexual desire (77.6%), avoiding intimacy (75.9%), vaginal dryness (66.5%), hot flushes, night sweats and sweating (63.3% each) respectively. QoL impairment by 66.7%, 46.3%, 37.8% and 75.6% was seen for vasomotor, psychosocial, physical and sexual domains respectively. Overall quality of life was affected by 58.6%. Among sociodemographic factors, occupation, family type, socioeconomic status, religion and marital status affected the QoL. Among clinical factors, chronic illness and addictions had a protective effect against QoL decline while duration of menopause and high BMI and specific comorbidities affected the QoL adversely. The findings of study showed a high impact of menopause on QoL of women. Sociodemographic and clinical factors had deterministic effects on QoL decline that need to be explored further using an exhaustive assessment in a larger study population in view of their study-specific roles in different studies. Conclusion: This cross-sectional study evaluated symptoms and quality of life (QoL) among 245 post-menopausal women in rural Barabanki using the MENQOL questionnaire. Common symptoms included fatigue, reduced physical strength, and decreased sexual desire. The sexual and vasomotor domains were most severely impacted, with an overall QoL reduction of 58.6%. Poor QoL was significantly associated with factors such as occupation, joint family status, lower socioeconomic class, higher BMI, and longer time since menopause. Addictions, particularly to tobacco and betel+tobacco, were linked to lower QoL scores. The study highlights a substantial burden of menopausal symptoms and impaired QoL, particularly in sexual and psychosocial domains, among women from socioeconomically disadvantaged rural settings.