This study aims to examine premenstrual syndrome (PMS) in university students and their coping behaviors. 452 female students were included in this descriptive and correlational study. The data were collected using a descriptive information form, the Premenstrual Syndrome Scale (PMSS), and the Premenstrual Change Coping Inventory (PMS-Cope). PMS symptoms were found in 80.5% of students. Seeking positive affect-inducing activities to cope with PMS was found to be a significant predictor of reducing the severity of PMS (beta =-0.265, p < .001). In coping with PMS, it is necessary to consider the perceptions of taking medication, seeking social support, or seeking positive affect-inducing activities as a coping method to determine the social and cultural beliefs of university students and control PMS. PMS is a significant health problem and raising awareness of the issue alone may not be enough. It should also be noted that the severity of PMS can vary markedly between ethnic groups, and women's strategies for coping with symptoms and their effectiveness may differ between cultures. It is pivotal to develop strategies for university students to cope with PMS and provide personalized care.