Background <p>More than 50% of menstruating women are affected by dysmenorrhea. Self-medication (SM) for dysmenorrhea among students is widespread. A systematic review and meta-analysis was conducted to estimate the pooled prevalence, examine medication use patterns for self-medication, and identify associated factors.</p> Methods <p>Data extraction was performed from September 2024 to November 2024 using three databases: PubMed Central, Scopus, and DOAJ. Eight articles were included, and the pooled prevalence of SM for dysmenorrhea was estimated at a 95% confidence interval using a random effects model, considering potential heterogeneity.</p> Results <p>Of the eight studies, an equal number (33.5%, n = 3) of studies were conducted in two large Indian states, Karnataka and Maharashtra, with publication years ranging from 2012 to 2023. The total sample across the included studies was 2544 [Median = 304, IQR = 226–381], with individual samples ranging from 70 to 641. Paracetamol and a combination of mefenamic acid and dicyclomine were the most frequently used medications, whilst metamizole and opioid drugs were the least used. The convenience of practising SM was cited as the most common factor. The pooled prevalence of SM for dysmenorrhea among students, based on the eight included studies, was estimated at 39% (95% CI: 24%-54%). The random effects model indicated considerable heterogeneity (I² = 98.41%). The funnel plot, Egger’s test, Begg’s test, and Trim-and-Fill methods were employed to assess publication bias, which showed no statistical significance.</p> Conclusion <p>SM for dysmenorrhea is common among Indian students. Paracetamol and a combination of mefenamic acid and dicyclomine are the most frequently used drugs. Implementing health education and improving access to healthcare are crucial to promoting safer medication practices.</p>