Background: Osteoporosis remains a serious public health issue around the world, especially among menopausal women, hence prevention is essential. Aim: To evaluate the effect of educational intervention based on the PRECEDE-PROCEED model (PPM) on osteoporosis preventive behaviors among perimenopausal women. Design: A quasi-experimental design was used. Setting: The research was carried out at Benha University Hospital's Obstetrics and Gynecology Clinic. Sample: A purposive sample of 109 perimenopausal women was randomly assigned to one of two groups (54 women in the control group and 55 women in the study group). Tools: Three tools were used for data collection: a structured interview questionnaire, a self-report-based health preventive behavior questionnaire a timetable, and a questionnaire on the construction of an antecedent model. Results: There was highly statistically significant difference was observed in all construction of the Precede-Proceed model of the study group compared with the control group after the application of health education based on  PRECEDE - PRECEDE model (p < 0.001). Conclusion: applying PPM can positively affect osteoporosis preventive behaviors and result in improving women's knowledge, attitude, behavior, reinforcing factors, and enabling factors which supported the present study hypothesis. Recommendations: Application of a PRECEDE-PROCEED model-based awareness program in the healthcare system to enhance knowledge of osteoporosis and its prevention in perimenopausal women. To improve awareness of menopause and the long-term consequences of more effective coping mechanisms, educational programs for menopausal women should be developed.