Background:Atrophic vaginitis is inflammation of vagina due to thinning and shrinking of tissue as well as decrease lubrication due to estrogen deficiency. As estrogen level drops after menopause, the vaginal tissue become atrophic, leading to various urogenital symptoms. Objective: To correlate clinical signs and symptoms with vaginal maturation value for diagnosis and assessment of severity. Methods: In this prospective study,100 postmenopausal attending gynecology OPD in KGMU Lucknow, inquired for the symptoms of atrophic vaginitis, out of which 49 came out symptomatic and were included in study. Apart from detailed history and examination, vaginal maturation value (VMV) assessment was done. Results: Symptoms of dryness, burning, perineal pressure, something coming out vagina and increase frequency of micturition were significantly more common in severe atrophic vaginitis. Dry vagina, shiny flat vaginal mucosa, narrow vaginal introitus and genital organ prolapse were significantly more common in severe atrophic vaginitis in comparison to mild atrophic vaginitis. Conclusion: To conclude, severity of atrophic vaginitis can be assessed by signs and symptoms and treatment can be started on basis of symptomatology only.