Background: Premenstrual syndrome (PMS) is a cyclical phenomenon of physical and emotional symptoms in which women's day-to-day functioning is impacted by intense side effects that significantly interfere with her personal happiness. Objective: The aim of this study was to estimate the prevalence of PMS among female students in university of Hail, Saudi Arabia. Methods: This cross-sectional study was conducted in University of Hail. A total of 530 female students participated in the study. The clinical criterion of American College of Obstetricians and Gynecologists (ACOG) for PMS was used to assess the prevalence of PMS in the participants. The questionnaire was set in six parts to assess the knowledge, the attitude, and practices regarding PMS. Results: The majority (95.3%) of the females were single, and 55.8% were enrolled in medical universities. Females who had PMS were 42.8%, 37.7% were unaware, while 18.7% did not have PMS. The majority (78.33%, n=412) of the participants reported that PMS disturbed their normal routine. Conclusion: A significant impact of PMS was found in the lives of women in Hail University, and it is also a common problem all over the globe. Despite the growing awareness, there remains a considerable deficiency of knowledge about the necessity to consult a doctor or seek treatment for the symptoms.