Background: The disorders related to menstruation are the greatest common gynecologic diseases. Premenstrual syndrome (PMS) represents a common problem among females from all age groups due to several factors. It can deteriorate their quality of life and social life. Objective: Assessment of the prevalence and predictors of premenstrual syndrome among female students at governmental secondary schools in Jeddah, Saudi Arabia, 2018. Materials and methods: The governmental female secondary students were the population for this study which included 64926 students. The sample size is calculated using Rao soft calculator. The schools and students were chosen by a multistage probability sampling method. Slight modification and validation by three consultants to construct the questionnaire. Results: Four hundred female students were included with mean age of 16.7 ± 1.16 years old. The prevalence of PMS was 37.0% (95% CI=32.3% - 41.9%). There were more participants in the 3rd year (35.8% versus 24.6%, p=0.00) and more Saudis (55.4% versus 44.4%, p=0.00) in the PMS group. In Saudi Arabia, other studies showed variable prevalence figures compared to those reported in our study. 35.6% of medical students at King Faisal University had a family history of dysmenorrhea as a risk factor of PMS. Conclusion: PMS is prevalent among one-third of secondary school students, Jeddah. Menstrual pain was the most common symptom, passive or active smoking and family history of dysmenorrhea were the predictors of PMS.