Background: Dysmenorrhea is defined as a cyclic lower abdominal or pelvic pain that may be radiating to the lower back, legs and inner thighs. It has a significant impact on quality of life, causing many adolescent and young women to be absent from their responsibilities due to pain. Objective: The current study aimed to assess prevalence of dysmenorrhea, to assess QOL in adolescent females with dysmenorrhea and to identify associated risk factors of dysmenorrhea among adolescent females at Zagazig secondary schools. Subjects and methods: This study is a cross sectional study included (287) subjects who were selected by a multistage sampling technique from 39 secondary schools at Zagazig district. The prevalence of dysmenorrhea, associated risk factors and its effect on quality of life among adolescent female students were assessed using four standardized questionnaires. Results: The present study revealed that Dysmenorrhea was reported in 89.9% of studied girls. Near half of participants (48.8%) reported severe pain. There was statistically significant relation between presence of dysmenorrhea and all of mood disturbance, change in appetite, sense of bloating, and fatigue. Among factors significantly related to poor QOL among studied girls, urban residence, dysmenorrhea, irregular menses, and fatigue during menses significantly increase risk of poor QOL by 2.101, 6.983, 1.682 and 2.241 folds respectively. Conclusion: dysmenorrhea significantly reduces quality of life in adolescent girls. And Dysmenorrhea is the most important predictor of poor quality of life among factors significantly related to poor QOL among studied girls.