Background: Menstruation, a unique phenomenon is a part of the female reproductive cycle starts when girls become sexually mature at the time of puberty. It is the most important physical change occurring among girls. Menstrual hygiene management is an important issue for adolescent girls due to lack of experience and lack of required information in parents in managing the related issues of menstrual cycle. Objectives: The overall objective of the study was to assess knowledge, attitude and practices of menstrual hygiene among rural adolescent school girls. Materials and Methods: A total sample of 210 adolescent school girls was taken. Probablility cluster sampling was used. Semi-structured self-administered questionnaire was provided to assess knowledge attitude and practices of menstrual hygiene. Ethical approval was taken from Sanjeevani College of Medical Sciences. Results: The mean age of the respondents was 14.17±1.25 years ranging from age 11 to 17 years. The mean age at menarche was 12.47±1.02 years. More than two third of the respondent (67.1%) had faced physical symptoms of abdominal and back pain at menarche. Mean days of interval for occurrence of menstruation and average duration of menstruation flow was 32.14±7.47 days and 5.49±1.59 days. All of the respondents (100%) answered cleaning of genital during menstruation. Conclusion: Menstrual hygiene is one of the important aspects in every women life. Although knowledge and practices of hygiene was good but there is still deep rooted social and cultural taboos in the society. So, there is a need of effective interventions to address the restrictions.