To investigate the menarche and the menstruation patterns of female students in Mongolian areas of China. Methods: Cross-sectional cluster sampling was used to investigate the menstruation pattern of the female students in Tongliao from 2013 to 2018 by one-to-one and face-to-face interviews under the unified standard. Results: A total of 4052 female students (1872 Han nationality and 2180 Mongolian nationality) were investigated, with a success rate of 97.1%. The mean age of the menarche of the female students was 12.9±1.1 years old, and which of the Han and Mongolian female students were 12.8±1.1 years old and 12.9±1.1 years old. There was significant difference in the mean age of menarche between the Han female students and the Mongolian female students (t=4.30, P=0.000). The incidences of the second menstrual period of the female students within 1, 2, 4 and 6 months after menarche were 65.8%, 82.1%, 92.9% and 97.7%, respectively. The cumulative rates of the menstruation stable state of the female students within 1, 2, 4 and 6 months after menarche were 65.8%, 82.1%, 92.9% and 97.7%, respectively. The time of the menstruation stable state of the female students from rural area was significantly earlier than that of the female students from urban area (χ2=21.49, P=0.001). The proportion of the female students with normal menstrual cycle was 72.2%, and which had significant difference of the female students between Han nationality and Mongolian nationality (χ2=4.05, P=0.044). The proportion of the menstrual period of 4-7 days of the female students accounted for 81.1%. The proportions of the little, less, average, more and much more menstrual volume of the female students were 4.7%, 7.9%, 69.1%, 10.7% and 7.6%, respectively. Most female students had dysmenorrhea, and the rate of the dysmenorrhea of female students had increased gradually with their prolong menstruation (52.5%-84.1%). The dysmenorrhea degree of the female students included the mild dysmenorrhea of 72.1% (the slight dysmenorrhea of 47.3% and the general dysmenorrhea of 24.7%), the moderate dysmenorrhea of 26.5% and the severe dysmenorrhea of 1.5%, and there was significant difference in the dysmenorrhea degree of the female students between the urban area and the rural area (χ2=20.52,P=0.000). Conclusion: The menarche age of the Han female students is earlier than that of the Mongolian female students in Mongolian areas. The female students from rural areas enter the menstrual stable state after menarche early. There are differences in the menstrual cycle between the Han female students and the Mongolian female students. Most female students have dysmenorrhea, but their dysmenorrhea degree is mild. There is significant difference in the dysmenorrhea degree of the female students the between the urban area and the rural area.