Background: Primary dysmenorrhea (PD) is menstrual pain not associated with any pelvic pathology. It is one of the most common gynecologic complaints in young women. In Uganda, there is scarcity of literature on the PD-associated symptoms and management strategies used by women of reproductive age. This study aimed to describe primary dysmenorrhea-associated symptoms and management strategies used by undergraduate students in northern Uganda. Methods: This was a descriptive cross-sectional study conducted among female undergraduate students of Lira University in northern Uganda. Systematic sampling was used to select study participants who met the inclusion criteria until the total of 232 study participants were recruited. The data was collected using a self‑administered questionnaire. Data analysis was aided by Statistical Package for Social Sciences (SPSS) (version 23) and descriptive statistics were used. Results: The prevalence of PD was 211/232(90.9%). The most commonly experienced dysmenorrhea-associated symptoms were change in appetite 79/211(36.0%), breast engorgement 84/211(39.8%), and depressed mood 107/211(51.4%). Pain relievers were the most commonly used management strategy 160/211(77%) with Paracetamol being the most commonly used pain reliever 62/211 (29.8%). The most commonly used non-pharmacological management strategies were; exercise 100/211(47.6%), resting 94/211(44.5 %) and relaxation 93/211(44.1%). Conclusion: A broad range of primary dysmenorrhea-associated symptoms are experienced by undergraduate university females but they do not use the appropriate management strategies. All University authorities should prioritize menstrual health and design programs to educate the female students on the management of dysmenorrhea associated symptoms using both pharmacological and non-pharmacological strategies and make the drugs available and accessible.