Background Menopause is one of the natural phenomena in every woman’s life. The transition phase gradually brings lots of changes in the life of women, both physically and mentally. In Nepal, these changes are often viewed as the symptoms of old age. This study aims to determine the prevalence of menopausal symptoms and their quality of life (QOL). Methods A descriptive cross-sectional study was conducted in a rural municipality of Jhapa district, Nepal, with study samples of 215 collected using purposive sampling technique. Semistructured questionnaire and MENQOL questionnaire were used for data collection. Descriptive (mean, standard deviation, frequency and percentage) and inferential statistics (t-test and ANOVA test) were used for data analysis. The confidence interval was taken as 95% and probability of significance at p < 0.05. Results The study showed that the mean age of the respondents was 53.51 ± 4.42 years with the mean age at menopause being 47.18 ± 6.16 years. The most prevalent symptoms among postmenopausal women were feeling tired or worn out (98.8%), followed by decrease in stamina (94%), decrease in physical strength (91.2%) and lack of energy (90%). The highest mean score was seen in physical domain (2.88 ± 1.61) followed by sexual (2.77 ± 1.93), vasomotor (2.65 ± 1.84) and psychosocial (2.45 ± 1.55). The overall mean score of QOL was found to be 80.06 ± 24.52. Marital status, number of children, educational status, occupational status and health seeking behaviour had significant association with the QOL score. Conclusion The most common symptoms experienced by the postmenopausal women were the physical symptoms followed by sexual, vasomotor and psychosocial. Presence of these symptoms certainly affects the QOL. Hence, effective awareness and education programme regarding the symptoms and ways to minimize those symptoms should be planned and provided both at individual and community levels.