Objective: To explore the value of gastric filling ultrasound in the quantitative assessment of gastric motility in perimenopausal women, and to identify potential factors affecting gastric emptying function during this stage. Methods: A total of 82 healthy women aged 45～55 were enrolled and divided into three groups based on the modified Kupperman score: normal group (n=14), mild symptom group (n=46), and moderate symptom group (n=22). Gastric motility and emptying parameters were measured and compared among the three groups. Correlations between various symptoms and gastric function parameters were analyzed, and factors influencing gastric emptying function were evaluated. Results: There were statistically significant differences among the three groups in terms of gastric wall thickening rate and gastric emptying rate at various time points (P<0.05). Correlation analysis showed that sensory disturbances, insomnia, dizziness, headache, and palpitations were negatively correlated with the gastric wall thickening rate (P<0.05). Depression, insomnia, anxiety, osteoarticular pain, and headache were negatively correlated with the gastric emptying rate (P<0.05). Multiple linear regression analysis revealed that depression and insomnia were factors affecting gastric emptying function in perimenopausal women, with depression being the primary factor. Conclusion: Women with more pronounced perimenopausal symptoms exhibit significantly reduced gastric emptying function, with depression being the main influencing factor. gastric filling ultrasound is a real-time, non-invasive, and quantitative method for assessing gastric motility in perimenopausal women. For women in this stage, timely psychological counseling and improvements in sleep quality should be key measures to improve gastrointestinal function.