Journal of Social & Health Sciences2959-96602958-65262022-09-154152310.58398/0001.000020articleAlia IbrahimMariyam SarfrazAashifa YaqoobSyeda Areesha Ali NaqviHealth Services Academy, Islamabad, PakistanHealth Services Academy, Islamabad, PakistanHealth Services Academy, Islamabad, PakistanHealth Services Academy, Islamabad, PakistanPremenstrual syndrome (PMS) affects many adolescent girls in terms of physique, behavior, and psychology. However, evidence regarding the association between PMS severity and academic performance among adolescents in peri-urban areas of Pakistan remains limited. This cross-sectional analytical study was conducted from May to September 2024 among 270 adolescent girls enrolled in secondary and higher secondary schools in Bara Kahu, Islamabad, using multistage cluster sampling. This study determined the frequency and severity of PMS and examined its association with academic performance. Overall, 85.93% of the participants reported PMS symptoms, with 35.19% experiencing mild, 30.00% moderate, 12.59% severe, and 8.15% very severe symptoms. For inferential analysis, PMS severity was categorized into mild, moderate, and severe levels. A statistically significant association was observed between PMS severity and academic performance (χ² = 34.565; p < 0.001). Spearman’s rank correlation further demonstrated a significant negative correlation between PMS severity and academic performance (ρ = −0.356, p < 0.01), indicating poorer academic performance with increasing symptom severity. These findings suggest that greater PMS severity is associated with reduced academic performance among adolescent girls in peri-urban Islamabad. While causality cannot be inferred because of the cross-sectional design, the results highlight the relevance of menstrual health in educational contexts during adolescence.