Background: Hot flashes affect as many as 75% of menopausal women. Estrogen reliably reduces the severity of hot flashes and remain the single most effective treatment. Today, however, more and more women are seeking alternatives. Instead of hormonal therapy, women are turning to vitamins, and other over-the-counter products for relief from hot flashes. This study was undertaken to assess the effect of vitamin E on hot flashes. Method: A placebo double blind-controlled trial was conducted. After 1 week baseline period, the enrolled patients (n = 51) received placebo (identical in appearance to vitamin E softgel) daily for 4 weeks, followed by 1 week wash out and 400 IU vitamin E (softgel cap) daily for the next 4 weeks. Diary was used to measure hot flashes before and at the end of the study. Result: There were statistical significant differences in hot flashes severity score (2.37 ± 0.74, 1.80 ± 0.87) and their daily frequency (5.00 ± 3.34, 3.19 ± 2.74) after the treatments between the placebo and vitamin E therapies (p < 0.0001). Conclusion: Based on our trial, vitamin E is recommended for the treatment of hot flashes.