The effectiveness of various exercise types in improving sleep quality in menopausal women remains controversial. This network meta-analysis was designed to evaluate and rank the efficacy of five exercise modalities on sleep quality in peri-postmenopausal women. Five English databases and three Chinese databases were searched for randomized controlled trials (RCTs) published from inception to July 2024. Pairwise meta-analysis and frequentist network meta-analyses were performed based on the random effects model. The analysis revealed that younger menopausal women (age <= 55 years) (standardized mean difference (SMD) -2.00; 95% confidence interval (CI) -2.70 to -1.31), those with sleep disorders (SMD -2.29; 95% CI -2.79 to -1.78) and those from Asia (SMD -2.50, 95% CI -3.62 to -1.38) were able to derive greater health benefits. Flexibility exercise (low certainty) and aerobic exercise (low certainty), combined exercise (moderate certainty) and mind-body exercise (moderate certainty) significantly improved sleep quality. Combined exercise showed the highest efficacy (surface under the cumulative ranking curve (SUCRA) 93.5%), followed by flexibility exercise (SUCRA 76%), and these exercises also showed a positive effect on women's quality of life (SMD 0.49; 95% CI 0.13 to 0.84; p = 0.007). Future research should develop more acceptable exercise intervention models and use combined and flexibility exercises to explore the optimal parameters of exercise for menopausal women.

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