OBJECTIVE： To compare the efficacy and safety of levonorgestrel intrauterine system and mifepristone in the treatment of perimenopausal dysfunctional uterine bleeding. METHODS： 200 patients with perimenopausal dysfunctional uterine bleeding were randomly divided into observation group （100 cases） and control group （100 cases）. Patients in the observation group placed levonorgestrel  intrauterine system （containing levonorgestrel 52 mg）， patients in control group received Mifepristone capsule 10 mg/d，oral，the treatment course for 2 groups were 3 months. Clinical efficacy， endometrial thickness， menstruation（PBAC score）， hemoglobin level before and after treatment and incidence of adverse reaction in 2 groups were observed. RESULTS： After treatment， the total effective rate in observation group was significantly higher than control group， incidence of adverse reactions was significantly lower than control group， the differences were statistically significant （P＜0.01）. Before treatment， there were no significant differences in the endometrial thickness， PBAC score and hemoglobin level between 2 groups； after treatment， endometrial thickness and PBAC score were significantly lower than before， and observation group was lower than control group； hemoglobin level was significantly higher than before， and observation group was higher than control group， the differences were statistically significant （P＜0.01 or P＜0.05）. CONCLUSIONS： The efficacy and safety of levonorgestrel intrauterine system are significantly superior to mifepristone in the treatment of perimenopausal dysfunctional uterine bleeding.