Context Symptoms connected with vulvovaginal atrophy disturb more than 50% of women in the perimenopausal period, starting from the age of 40. The most common symptom reported by patients is vaginal dryness, but also very often ailments associated with the urinary incontinence. Objective The evaluation of the effectiveness of CO2 laser treatment of urogenital symptoms in perimeteropausal period. Methods For the study we qualified patients of perimenopausal age, over 45 years of age, who reported one or more urogenital symptoms such as dryness, burning, painful intercourses and urinary incontinence. Patients Before each visit, we had taken the detailed history of obstetric past, chronic diseases, surgery and taken medications. Each patient assessed reported ailments on a 10-degree scale. Interventions In the case of reporting problems related to urinary incontinence, the procedure was first performed using a 90-degree head, then using a 360-degree head. Patients who did not report problems in urinary incontinence had only the procedure performed with a 360-degree head. Main outcome measures The influence of CO2 laser treatment in the field of urogenital symptoms associated with vaginal atrophy. Results 183 patients with symptoms of urogenital syndrome were subjected to statistical analysis.154 patients entered the second stage of the laser procedure to the third stage of the procedure. The improvement was observed in the all symptoms. Patients who reported problems of stress urinary incontinence were divided into two groups depending on the degree of vaginal wall prolapse according to POPQ classification. We obtained the Improvement of symptoms in both groups. Similarly, we also assessed satisfaction with laser treatment in the group of women reporting isolated urgent urinary incontinence. We obtained a smaller effect compering to the group with stress urinary incontinence.The procedure was well tolerated by all the patients. Conclusion The obtained results indicate a significant effectiveness of CO2 laser treatment performed with the established technique. The most important factor affecting the achievement of the expected effectiveness is the correct classification of women for the above procedure. It is obvious that the above observations should continue to be able to assess long-term results regarding the duration of improvement in the quality of life associated with SUI.