Purpose: The aims of this study were to construct a hypothetical structural model which explains the premenstrual syndrome (PMS) in adolescent girls and to test the fitness with collected data. Methods: The participants were 1,087 adolescent girls from 3 high schools and 5 middle schools in B city. Data were collected from July 3 to October 15, 2012 using self-reported questionnaires and were analyzed using PASW 18.0 and AMOS 16.0 programs. Results: The overall fitness indices of hypothetical model were good (${chi}^2$ =1555, p<.001), ${chi}^2$/df=4.40, SRMR=.04, GFI=.91, RMSEA=.05, NFI=.90, TLI=.91, CFI=.92, AIC=1717). Out of 16 paths, 12 were statistically significant. Daily hassles had the greatest impact on PMS in the adolescent girls in this model. In addition, PMS in adolescent girls was directly affected by menarche age, Body Mass Index (BMI), amount of menstruation, test anxiety, social support, menstrual attitude and femininity but not by academic stress. This model explained 27% of the variance in PMS in adolescent girls. Conclusion: The findings from this study suggest that nursing interventions to reduce PMS in adolescent girls should address their daily hassles, test anxiety, menstrual attitude and BMI. Also, social support from their parents, friends, and teachers needs to be increased.