Background: Body image is a multidimensional construct which comprises of perceptual - body size estimation and appearance as well as attitudinal - relating to feelings and attitudes toward one’s own body. For menopausal women, weight gain is a common occurrence, and these body composition changes may influence how a woman feels about the way her body looks. Concerns about body image in menopausal women may sometimes lead to dissatisfaction with their bodies. In addition, the great pressure for a perfect body may influence either positively or negatively women‘s involvement in physical activity (PA). Objectives: This study assessed body image attitude of a sample of premenopausal and perimenopausal women in Nigeria and their PA level. Participants and Methods: The multidimensional body-self relations questionnaire-appearance scale (MBSRQ-AS) was used to evaluate appearance satisfaction, body image attitudes, and satisfaction while the International PA questionnaire was used to evaluate PA level. Data were summarized using descriptive statistics and analyzed using Chi-square while significance level was set at 0.05. Results: Participants were 392 women aged 42.5±6.0 years and all reported positive body image attitude. Premenopausal women reported higher scores in most domains of the MBSRQ-AS while perimenopausal women reported higher scores on the overweight preoccupation and self-classified weight. Majority reported moderate to high PA level. Significant associations were observed between PA level and scores on appearance evaluation (P = 0.02) and overweight preoccupation (P = 0.01) for premenopausal women while perimenopausal women reported significant association between PA level and scores for appearance orientation (P = 0.00), overweight preoccupation (P = 0.00), and self-classified weight (P = 0.01). Conclusions: Body image attitude appeared to have had a positive impact on PA level. It may be imperative for women in the menopausal transition to maintain a physically active lifestyle to enhance a positive body image.