Objective To assess the significance of IDEAL-IQ in quantitative evaluation of lumbar vertebral bone marrow and paraspinal muscle fat compositions in perimenopausal women. Methods IDEAL-IQ scans were performed on the lumbar spine in 80 volunteers. According to the time of menopause, the subjects were divided into the four groups: non-menopausal, 0 years＜menopausal time≤5 years, 5 years＜menopausal time≤10 years, and menopausal time＞10 years. One-way analysis of variance was used to compare the lumbar vertebral marrow fat percentage FFv and bilateral paraspinal muscle fat percentage FFLm and FFRm values in different groups. Pearson correlation analysis was performed on age, menopausal time and FFv, FFLm and FFRm values, respectively. Results The FFv, FFLm and FFRm values of different perimenopausal groups were statistically different (all P＜0.05). Age was positively correlated with FFv, FFLm and FFRm values (r=0.523, r=0.767, r=0.775, all P＜0.001). Menopausal time was positively correlated with FFv, FFLm and FFRm values (r=0.490, r=0.742, r=0.741, all P＜0.001). Conclusion IDEAL-IQ technology can quantitatively assess the fat content of lumbar vertebral bone marrow and paraspinal muscles in perimenopausal women, and has important guiding value in revealing the relationship between menopause time and the fat content of vertebral bone marrow and paraspinal muscles.