Early preparation for menarche is important for future childbearing and for a girl concept of herself as a female because it teaches her to trust her body and think of menstruation as a mark of pride or grown up. Premenarcheal preparations could be conceptualized as consisting of anticipation, communication, and action-related planning for an event (Thompson.2002). the aim of this study was to assess the pre-menarcheal health needs among early adolescent girls. This descriptive research study was conducted at all governmental female preparatory schools in El manzala City, Egypt. The total sample represented 500 student girls. Two tools of data collection was used included: a structured Self administered questionnaire and a menstrual attitude questionnaire. Results: The student girls had inadequate preparation for menarche and only 23.8/% of them were prepared for menarche before its occurrence. The student girls have had sufficient prior knowledge about menarche often feel unprepared for the event itself. The finding revealed that about 80% of girls in a need for more information about menstruation and half of them agreed on preparing girls for menarche at ten years old which reflects their ignorance about the importance of early preparations before they got menarche. More half of girls reported that menarche would be easy if they knew more information. Conclusions: The study was concluded that early adolescent student girls had inadequate preparation for menarche, and need more information. The study recommended the complete preparation for menarche before attaining it.