To determine the relationship between premenstrual symptoms and dysmenorrhea among Japanese adolescent girls, a total of 1,431 high school students were assessed. Of them, 11.3% were classified with "moderate to severe premenstrual syndrome (PMS)" and 3.2% with "premenstrual dysphoric disorder (PMDD)." Eighty-five percent of the girls had dysmenorrhea. The rates of prevalence of PMDD and moderate to severe PMS were increased according to the severity of dysmenorrhea (rs = 0.479), showing a correlation between the severity of PMS/PMDD and dysmenorrhea in adolescents.