Background: Due to the decrease of estrogen levels in postmenopausal females, menopause can be associated with musculoskeletal pains. This study was designed to assess the possible association between musculoskeletal pains, serum estradiol level, and climacteric symptoms in postmenopausal women.Methods: This cross-sectional study was conducted on 307 postmenopausal females selected by convenience sampling method. Data collection procedure lasted from October 2016 to September 2018. The required data were collected using the Menopause Rating Scale (MRS), Örebro Musculoskeletal Pain Questionnaire (ÖMPQ), and a questionnaire containing personal data. The blood sample was taken to measure the estradiol level. Results: There was a direct relationship between musculoskeletal pains and menopause symptoms (p<0.001), age (p=0.03), parity (p=0.01), and BMI (p=0.03) and an indirect association between musculoskeletal pain and marriage age (p=0.009), age of first pregnancy (0.017), estradiol level (p<0.001) and education level (p=0.002). The regression analysis results showed that menopause symptoms were the strongest predictor of musculoskeletal pains among all the variables.Conclusions: The findings of the present study showed that although various parameters are associated with musculoskeletal pains, climacteric symptoms are the most important predictive parameters of musculoskeletal pains.