Dysmenorrhea is among the most common gynecological problems affecting young women and remains a major contributor to academic absenteeism. In India, reported prevalence ranges from 50 percent to 87.8 percent, underscoring its public health relevance. However, evidence at the district level is limited. This study aimed to estimate the prevalence of dysmenorrhea and examine its associated factors among undergraduate female students aged 18 to 22 years in Berhampur, Odisha. An institutional based cross sectional study was conducted from May to July 2022 among 500 undergraduate students selected through multistage random sampling from eight colleges representing science, arts, and commerce streams. Data were collected using a structured questionnaire administered via the ODK Collector application, and analysis was performed using SPSS version 20. The prevalence of dysmenorrhea was 60.7 percent. The mean age at menarche was 13.08 years. Significant associations were observed with family history of dysmenorrhea, shorter duration of menstrual bleeding, class absenteeism, reduced concentration, menstrual absorbent disposal practices, low body mass index, and inadequate sleep duration. Regular exercise did not show a significant association. Dysmenorrhea had a clear negative impact on academic performance, particularly through absenteeism and impaired concentration. The findings highlight the high burden of dysmenorrhea among undergraduate students and its adverse effects on educational outcomes. Focused awareness programs, lifestyle interventions, and institutional support are essential to improve menstrual health and academic wellbeing. .