Objective  To explore factors related to hormone replacement therapy (HRT) in compliance of patients with climacteric syndrome.Methods A retrospective analysis was conducted on 105 patients with climacteric syndrome who received hormone replacement therapy from February 2014 to March 2018 in our hospital. The differences of factors affecting patients' HRT compliance were compared.Results Of the 105 patients, 40 (38.09%) had poor compliance and 65 (61.91%) had good compliance. Univariate analysis showed that education level, occupation, economic income, marital status, cognition, family support, medical expenses, medical conditions, adverse reactions and doctor-patient relationship all had significant effects on patient HRT compliance. Logistic regression analysis showed that low level of education, manual labor occupation, poor economic income, single marital status, lack of cognitive status, lack of family support, selfpay for medical expenses, inconvenient medical conditions, adverse reactions and poor doctorpatient relationship were risk factors for poor HRT compliance.Conclusion There are numerous factors affecting HRT compliance in menopausal syndrome. It is necessary to improve the compliance of HRT by combining the actual situation of patients and implementing targeted measures.