Background; Menstruation is regarded as a shameful period associated with physical, social and psychological effects to adolescent girls. This is due to lack of knowledge, social and cultural norms and poor menstrual hygiene management options and practices. Objectives: This study aims to assess knowledge, support and document current menstrual hygiene practices among adolescent secondary school girls. Methodology: A prospective cross sectional study involved adolescent girls at ages between 13- 19 years studying at Kelamfua and Horombo secondary schools in Rombo district. The schools were conveniently sampled due to its location and diversity of students attending those schools socially, culturally and financially. The 366 participants were randomly sampled from different classes of the two schools and data was collected through questionnaires followed by descriptive data analysis using through SPSS. Results: The level of knowledge among adolescents was as follows; 59.6% knew that menstrual cycle begins on the first day of bleeding, 49.7% knew that menstrual cycle ends between menstrual cycle, 67.2% knew that wetness meant preparation for menstruation and 45.9% knew that it is normal for menstrual cycle to change. On the other hand, 83.9% majority adolescents obtained their information from their mothers and 98.7% used commercial pads while 65.8% changed them 3 times per day. Conclusion: Menstruation is still a sensitive topic among adolescents and their caretakers due to cultural boundaries. This has led to poor knowledge about menstruation and thus poor menstrual hygiene practices among adolescents.