Girls’ education remains a significant challenge in sub-Saharan Africa as it is estimated that 1 in 10 adolescent girls miss school during their menstrual cycle. In Tanzania, girls must attend school regularly to be sufficiently prepared for the National Examinations that serve as gatekeepers to higher education levels and advanced careers. Our current study focuses on contextual factors that limit Tanzanian girls’ school attendance during menstruation (ADM). Using descriptive and inferential statistical techniques and survey data from post-menarche adolescent girls (N = 610) in the Mara region of Tanzania, the findings revealed that psychological, physiological, informational, and material factors increase the likelihood of girls’ school absenteeism during menstruation. The results from this study indicate that generalized anxiety, depression, worry about menstruation, menstruation preparation, and menstrual pad material have a direct impact on ADM. The findings from this study have implications for educational policy and school leadership