Objective: To analyze the changes and predictive value of antimullerian hormone (AMH) and sex hormones in perimenopausal women with osteoporosis. Methods: From June to Dec. in 2020, one hundred and fifty-seven perimenopausal women treated in Department of Gynecol. and Obstetrics, Hangzhou First People′s Hospital were selected as study object, then the perimenopausal women were divided into osteoporosis group (fifty-seven cases), osteopenia group (forty-eight cases), and normal bone mass group (fifty-two cases) according to the diagnostic criteria of osteoporosis. The levels of serum FSH (FSH), LH (LH), estradiol (E2), AMH, and parathyroid hormone (PTH) were detected, the levels of sex hormones and AMH in the three groups were compared, Pearson correlation coefficient was used to analyze the correlations between each indicator. Results: The levels of serum AMH, FSH, LH, E2, and PTH in osteoporosis group were (0.25±0.15) ng/mL, (29.12±5.00) IU/L, (15.81±2.98) IU/L, (16.70±3.63) pg/mL, and (46.60±6.07) pg/mL, resp.; the levels of serum AMH, FSH, LH, E2, and PTH in osteopenia group were (0.57±0.39) ng/mL, (26.42±5.04) IU/L, (10.34±2.92) IU/L, (25.10±5.11) pg/mL, and (40.72±3.05) pg/mL, resp.; the levels of serum AMH, FSH, LH, E2, and PTH in normal bone mass group were (0.89±0.98) ng/mL, (20.39±2.72) IU/L, (7.66±2.73) IU/L, (36.64±12.93) pg/mL, and (34.38±3.53) pg/mL, resp. There were statistically significant differences in the levels of serum AMH, FSH, LH, E2, and PTH among the three groups (F=111.215, 51.734, 103.754, 173.134, 143.873, P<0.05). The levels of serum AMH and E2 in osteoporosis group were statistically significantly lower than those in osteopenia group (t=-5.717, P<0.05; t=-9.817, P<0.05); the levels of serum FSH, LH, and PTH in osteoporosis group were statistically significantly higher than those in osteopenia group (t=2.746, P<0.05; t=9.456, P<0.05; t=6.092, P<0.05). The levels of serum AMH and E2 in osteopenia group were statistically significantly lower than those in normal bone mass group (t=-2.112, P<0.05; t=-5.779, P<0.05); the levels of serum FSH, LH, and PTH in osteopenia group were statistically significantly higher than those in normal bone mass group (t=7.524, P<0.05; t=4.743, P<0.05; t=9.574, P<0.05). Pearson correlation anal. showed that AMH was neg. correlated with FSH, LH, and PTH (r=-0.505, -0.271, -0.227, P<0.05), AMH was pos. correlated with E2 (r=0.390, P<0.05). PTH was pos. correlated with FSH and LH (r=0.378, P<0.05; r=0.439, P<0.05), PTH was neg. correlated with E2 and AMH (r=-0.516, P<0.05; r=-0.227, P<0.05). Conclusion: Serum sex hormones and AMH levels can predict osteoporosis in perimenopausal women, when ovarian decline is observed in perimenopausal women, monitoring of osteoporosis should be further enhanced and interventional measures should be taken to improve life quality of perimenopausal women.