Purpose: This study was designed to construct and test structural equation modeling on healthy menopausal transition in middle-agedwomen in order to identify variables affecting healthy menopausal transition. Methods: Participants, 276 women, 45 to 60 years of age,with menopausal symptom score higher than 5 on the Korean version of Menopause Rating Scale, were recruited in three cities and onecounty of Gyeongnam Province. Research data were collected via questionnaires and analysed using SPSS version 18.0 and AMOS version20.0. Results: After confirmatory factor analysis, one of the observed variables was excluded due to relatively low factor loading. The model fit indices for the hypothetical model were suitable for the recommended level: GFI=.93, CFI=.92, RMSEA=0.05. Self-efficacy,self-differentiation, and menopausal symptoms explained 67.7% of variance in menopausal transition, and self-differentiation was themost influential factor for menopausal transition. Self efficacy and menopausal symptoms explained 9.6% of variance in menopausalmanagement, although “menopausal symptoms” was not significant. Conclusion: These results suggest that nursing interventions toimprove self-differentiation, self efficacy, menopausal management and decrease menopausal symptoms are critical for healthy menopausaltransition in middle-aged women. Continued development of a variety of community-based nursing interventions to facilitatehealthy menopausal transition is suggested.