Background Irritable bowel syndrome (IBS) is a common chronic gastrointestinal condition associated with many modifiable and non-modifiable risk factors. Objectives To determine the prevalence of IBS and the associated risk factors among female secondary school students in Ar Rass city, Qassim region, Saudi Arabia. Methods A cross-sectional study was conducted from June to August 2021 among female students attending government secondary schools at Ar Rass city, Qassim region. Two schools were selected by simple random sampling. A self-administered questionnaire using Google Form, submitted to the WhatsApp groups of the students, gathered personal data, and behavioral, lifestyle and health background characteristics of the participants. The questionnaire included Rome IV criteria for IBS diagnosis. Results Out of 612 invited students, 429 responded (response rate: 70.1%). Twenty-eight incomplete questionnaires were excluded leading to 401 participants in the final analysis. The mean (± SD) age of study participants was 17.3 (±2.05) years. The overall prevalence of IBS was 21.4% (n=86); 11.7% (n=47) were already diagnosed; however, 9.7% (n=39) were newly detected in our survey. The factors associated with IBS included frequent consumption of soft drinks (p=0.016), low vegetable consumption (p=0.003), poor mental health (p<0.0001), family history of IBS (p<0.0001) and history of chronic disease (p<0.0001). Conclusion IBS is prevalent among female secondary school students in Ar Rass city. Unhealthy diet and poor mental health are associated with IBS. Creating awareness regarding IBS and about importance of healthy lifestyle is recommended. School staff need to be trained to promote the physical and mental health of the students.