Background: Gender inequality, cultural taboos, poverty and lack of proper information can cause menstrual health needs to go unmet. It restricts mobility, personal choices, work participation and well-being. Nevertheless, self-efficacy in the menstrual hygiene management of college students has been relatively unexplored. Objectives: We aimed to assess the self-efficacy of menstrual hygiene management and its association with college absenteeism, demographic and academic profiles. The study also aimed to explore concerns and beliefs related to menstruation. Materials and methods: A cross-sectional descriptive mixed-method study was conducted to assess the self-efficacy of the menstrual hygiene management (using a novel scale) of students from a general college in Kolkata, West Bengal, India. The study also explored concerns and beliefs related to menstruation among the study subjects. The sample size was calculated to be 96. For the qualitative part, 30 willing students were purposively chosen. Results: The mean age of participants was 19.38 years (SD ± 1.23). Predominantly they belonged to nuclear families (65.6%) with a median family income of ₹12,000. Absenteeism for menstrual reasons was 12 (12.5%). There were 50 (52.1%) participants who reported facing religious restrictions. Self-efficacy had a mean score of 29.90 (standard error of mean = 0.513) and a median score of 31. The presence of religious restrictions, any restrictions and type of family were significantly associated with college absenteeism by the chi-square test ( P < .05). The logistic regression model showed a significant association with religious restriction. Conclusion: The study revealed multiple concerns of college-going students regarding menstrual hygiene despite reported high self-efficacy for menstrual hygiene management.