Objective: The aim of the study was to evaluate whether climacteric symptoms are related to urinary incontinence (UI) in postmenopausal women. Methods: A cross-sectional investigation was performed on 1,502 postmenopausal women attending the outpatient service for menopause at a University Hospital. Data regarding climacteric symptoms, evaluated by the Greene Climacteric Scale, objective pelvic floor defects, and UI of any type, were retrieved from an electronic database. Additional information retrieved were age, anthropometric measures, personal and reproductive history, use of medication or drugs, smoking, state of anxiety (State-Trait Anxiety Inventory scale score), and depression (Zung's scale score). Results: The score of the Greene Climacteric Scale was higher (P = 0.0001) in women with (n = 534) than without (n = 902) UI (32.3 +/- 13.1 vs 26.5 +/- 12.5; P < 0.0011). The same was true when considering stress (n = 370) (31.4 +/- 13.4; P = 0.0007), urge (n = 84) (34.5 +/- 13.5; P = 0.005), or mixed (n = 89) (34.3 +/- 11.4; P = 0.006) UI. In multiple logistic regression models, the Greene climacteric score was independently related to UI (odds ratio [OR] 1.05; 95% CI, 1.03-1.07), along with the presence of a bladder prolapse (OR 3.72; 95% CI, 2.59-5.34), age at menopause (OR 1.05; 95% CI, 1.01-1.09), and previous hysterectomy (OR 1.80; 95% CI, 1.08-3.01). Women in the fourth quartile of the Greene Climacteric Scale score had an OR of UI of 2.09 (95% CI, 1.5-2.9). Conclusions: In postmenopausal women, higher symptom burden, as captured by the Greene Climacteric Scale, relates to UI. Underlying mechanisms were not assessed, and deserve further investigation.