Objective: To determine the menstrual characteristic and its related morbidities among adolescent girls living in Sabah of North Borneo, Malaysia. Design: Cross-sectional study. Setting: Three government high schools located in Ranau, Sabah. Population or Sample: A total of 757 girls aged between 14 and 19 years. The participants were female adolescent volunteers who have attained menarche. Methods: Data were based on a quantitative survey. Main Outcome Measures: Based on the analysis of questionnaires completed by 757 adolescent girls, the mean age was 17 ± 1.4, and the mean menarche age was 12.2 ± 1.1. Our data demonstrated that 85.7% of the participants experienced dysmenorrhea, of which at least 42% (mean pain score±SD: 4.81±0.76, 95% CI: 4.7, 4.9) experienced moderate dysmenorrhoea and 11.3% (mean pain score ± SD: 7.86±0.97, 95% CI: 7.6, 8.1) documented severe dysmenorrhea. More than 70% of these girls complained of tiredness, headache, and appetite change during their menses. Conclusion: The prevalence of menstrual disorders and its related morbidities among girls residing in Sabah is high. Reproductive health issues remain poorly addressed in rural and socio-economic deprived areas. The main consequence of neglecting menstrual disorder and its related morbidities is impaired future sexual reproductive health as an adult. Hence, addressing adolescent reproductive health issues is crucial, especially among girls living in areas where healthcare accessibility is difficult. Information gathered from this study is required to strategise an effective intervention to improve adolescents’ reproductive health status in rural areas.