Context: The aim of this study was to systematically review published articles reporting on the prevalence of vasomotor and sexual symptoms in Iranian women.Evidence Acquisition: Five databases including MEDLINE, PsycINFO, CINAHL, SCOPUS and Google scholar, as well as four Iranian databases including SID, Iranmedex, IranDoc and Magiran were searched during July 2016 to retrieve studies reporting on the prevalence of vasomotor and sexual symptoms in Iranian middle-aged women. Risk of bias was assessed using a standard risk of bias tool.Results: Twelve independent studies met our inclusion criteria and provided data for this review. The prevalence of vasomotor and sexual symptoms was high although the ranges were wide. This might be due to utilization of different study designs, methods of recruitment, instruments, and the time frame over which symptoms were assessed. There was a lack of information in most studies on the severity of symptoms as an important determining factor for clinical use. In addition, distress associated with sexual symptoms has not been assessed by any study. High risk of bias was observed for the eleven studies for both external and internal validity.Conclusions: High quality research is needed to establish the true portray for the prevalence and severity of vasomotor and sexual symptoms associated with distress in Iranian women.