Background: Menopause is the permanent absence of menstruation resulting from the cessation of ovarian follicular activity. Even though, menopause is part of natural and biological event in a woman’s life, high proportion of women suffer with minor to major menopausal related problems. So, knowing certain changes and symptoms during this period could help them to cope with these symptoms with a greater readiness. Little is known on knowledge on menopausal symptoms in Ethiopia particularly in the study area. Objective: This study aimed to assess knowledge and associated factors of menopausal symptoms among women aged 40 - 65 in Motta district, Northwest, Ethiopia, 2020. Methods: Community based cross-sectional study design was employed from March 17 to 30/ 2020 in the Motta district. Simple random sampling technique was used for the required sample size. The data was collected by using pretested interviewer-administered questionnaires and entered in to Epi data version 3.1 then exported to Statistical Package for Social Science version 25 for analysis. Bivariable and multivariable logistic regression was employed and variables at p-value < 0.05 with 95% confidence interval were identified as significant factors to the outcome variable. Results: The prevalence of knowledge on menopausal symptoms was 28.5% [95%CI =24.4, 32.5%)]. Urban dweller [AOR =3.12, 95%CI=(1.61, 6.35)], secondary education level of women [AOR=3.47, 95%CI =(1.65, 7.31)], women in rich wealth status [AOR=2.59, 95%CI= (1.37, 4.89)], women who had information about menopause [AOR=3.15, 95%CI= (1.78, 5.57)], post-menopausal women [AOR= 2.8, 95%CI=(1.19, 6.53)] and women who had severe score of menopausal symptoms [AOR=3.21, 95%CI=(1.64, 6.28)] were significantly associated with knowledge on menopausal symptoms. Conclusion and recommendation: Generally the prevalence of knowledge on menopausal symptoms was low. Large efforts are required to educate and make the women aware of menopausal symptoms including rural women. Keywords: Knowledge, Menopausal symptoms, Motta district