Premenstrual syndrome (PMS) refers to a group of expectable physical, cognitive, affective, and behavioral symptoms that are observed cyclically during the luteal phase of the menstrual cycle and resolve immediately in a few days at the beginning of menstruation. [3] Various studies in India have observed an incidence of PMS to be 20% in general population, with 8% revealing severe symptoms [4] American College of Obstetrician and Gynecologist (ACOG) put forward criteria, which consist of any one of the affective symptoms (depression, angry outbursts, irritability, anxiety, confusion, and social withdrawal) and somatic symptoms (breast tenderness, abdominal bloating, headache, and swelling of extremities). These symptoms should occur in the three prior menstrual cycles during the 5 days before the onset of menses, and the symptoms must resolve within 4 days of initiation of the menses and not relapse until after day 12 Background: Various studies in India have observed an incidence of premenstrual syndrome (PMS) to be 20% in general population, with 8% revealing severe symptoms. Objective: To study the sociodemographic characteristics of adolescent rural school girls, assess the prevalence of PMS among them, and find out the factors associated with PMS, if any. Materials and Methods: This was a descriptive study with cross-sectional design, conducted in Purba Medinipur district of West Bengal from July to August 2014. Multistage random sampling method was used. Totally, 244 students were included in the study. Data were analyzed with the help of statistical software SPSS, version 20.0, using mean, standard deviation, proportion, and χ 2-test. Result: PMS was reported by 61.5% of girls. Of the affective symptoms in ACOG criteria, 62.7% girls reported depression and 70.5% girls anger. Irritability was reported to be as high as 84.8%. Anxiety and confusion were reported by 76.0% and 66.8% adolescent girls, respectively. Around one-third of girls experienced breast pain, and 55.3% of girls have also faced social rejection during that period. Headache and abdominal distension were reported by around 55% students. Only 14.7% of them reported limb swelling in premenstrual period. PMS was found to be associated with mother's occupation, amount of blood flow during menstruation, and presence of dysmenorrhea (p < 0.05). Conclusion: PMS was found to be an important health problem of adolescent girl students in rural areas.