Introduction: Hygiene-related practices of adolescents during menstruation are of importance, as it has a health impact in terms of increased vulnerability to reproductive tract infections (RTI). Therefore, increased knowledge about menstruation right from childhood may escalate safe practices and may help in mitigating the suffering of women. Objectives: To assess the perceptions and practices regarding menstrual hygiene among selected high school girls in a resource limited settings in area around Bangalore city. Methodology: This was a cross sectional study done in four selected Government High Schools in rural areas around Bangalore City. A pre-designed, pre-tested and structured questionnaire was administered. Results: A total of 506 girls were interviewed. The average age was 14.08 with Standard deviation of 1.06 and range between 12-16yrs. 99.6% of the students had heard of menstruation and 57.9% had acquired this even knowledge before attaining menarche. 73.7% knew that menstruation was a normal phenomenon but only 28.7% had knowledge regarding menstruation. 48.1% did not know that menstruation was related to pregnancy. Only 44.1% used sanitary pad during the menstrual cycles. Among those who used cloth, only 31.3% used soap and water to clean them. 56.8% used soap and water to clean their genital organs and 88.8% of the girls took bath daily during menstruation.