ObjectiveTo examine the prevalence of overactive bladder (OAB) according to menopausal stages in middle‐aged women.DesignCross‐sectional study.SettingTotal Healthcare Center in South Korea.PopulationMiddle‐aged Korean women (n=3469, mean age, 49.5 ± 2.9 years).MethodsMenopausal stages were defined according to the Stages of Reproductive Aging Workshop +10 criteria, and menopausal symptoms were assessed using the Korean version of Menopause‐Specific Quality of Life (MENQOL). Logistic regression models were used to estimate prevalence ratios with 95% confidence intervals for OAB according to menopausal stage and to assess the associations with menopausal symptoms.Main Outcome MeasuresOAB symptoms were evaluated using the Overactive Bladder Symptom Score (OABSS).ResultsThe prevalence of OAB increased with menopausal stage; however, the multivariable‐adjusted prevalence ratios for women in menopausal transition and postmenopausal stage were insignificant (ptrend = 0.160) compared to those for premenopausal women. Among individual OAB symptoms, the multivariable‐adjusted prevalence ratios for nocturia increased with menopausal stage in a dose–response manner (ptrend = 0.005 for 1 time/day; ptrend < 0.001 for ≥2 times/day). The association between menopausal stages and nocturia occurring ≥2 times/day was evident in women without OAB and with relatively high MENQOL scores, vasomotor symptoms and difficulty sleeping.ConclusionsThe prevalence of OAB, particularly nocturia, increased with menopausal stage, and the association was obvious in women with other menopausal symptoms. This finding underscores the importance of addressing nocturia as a potential menopausal symptom in middle‐aged women. Further studies are required to understand the mechanisms linking OAB with menopausal symptoms in middle‐aged women.