Perimenopausal abnormal uterine bleeding-ovulatory dysfunction (AUB-O) is highly prevalent and its etiology and pathogenesis are intricate, significantly compromising physical and psychological health and their quality of life of perimenopausal women. Traditional Chinese medicine (TCM) and ethnic medicines possess unique advantages and proven efficacy in the treatment of perimenopausal AUB-O. At present, however, evidence-based, standardized clinical guidelines and systematic reviews are lacking. To maximize these therapeutic strengths, ensure rational and safe use of TCM and ethnic medicinal therapies, achieve precise correspondence between treatment principles and herbal formulations, and minimize adverse reactions, the China Ethnic Medicine Association convened a multidisciplinary panel of TCM, multi-ethnic medicines, integrated Chinese-Western medicine, Western medicine, pharmacy and methodology experts. Following evidence-based principles, the panel systematically evaluated the evidence on TCM and ethnic medicine for perimenopausal AUB-O, referenced the latest international and domestic guidelines, and developed the Expert Consensus on Multi-ethnic Medical Diagnosis and Treatment of Perimenopausal Abnormal Uterine Bleeding-Ovulatory Dysfunction, aiming to provide an authoritative, standardized and practical clinical guidance.