Background: Dysmenorrhea is the most common gynecologic complaint among adolescent and young adult females. Dysmenorrhea in adolescents and young adults is usually primary (functional), and is associated with normal ovulatory cycles and with no pelvic pathology. Potent prostaglandins and potent leukotrienes play an important role in generating dysmenorrhea symptoms. Aim: this paper aimed to review the topic by discussing its most recent definitions, pathophysiology, epidemiology, clinical presentation and management, as well as to offer a most current view on endometriosis in adolescents. Summary: Adolescents and young adults with symptoms that do not respond to treatment with NSAIDs for 3 menstrual periods should be offered combined estrogen/progestin oral contraceptive pills for 3 menstrual cycles. Adolescents and young adults with dysmenorrhea who do not respond to this treatment should be evaluated for secondary causes of dysmenorrhea. The care provider’s role is to explain about pathophysiology of dysmenorrhea to every adolescent and young adult female, address any concern that the patient has about her menstrual period, and review effective treatment options for dysmenorrhea with the patient.