Background: Menstrual hygiene management (MHM) among adolescents in rural India is negatively influenced by myths and taboos which predispose them to infections which can be dispelled by health education by experts or peers. The study aimed to demonstrate the relative effectiveness of direct health education over peer led health education on MHM.Methods: A longitudinal follow up intervention study recruiting 486 school going adolescent females divided in three groups I, II and III was conducted. Group I received peer led, while group II received direct health education and group III was control. Pre and post intervention scores of participants were compared.Results: Direct intervention group demonstrated highest improvement in number of participants having good MHM scores (p<0.05). Mean MHM scores of direct intervention group participants were the highest among all the three groups (p<0.05). Knowledge score of direct intervention group was significantly higher than group 1 (p=0.001) and group III with no difference in practice scores between group I and II (p=0.147).Conclusions: Direct health education as an intervention is more relatively effective than peer led in MHM of adolescent females.