Background: Menstruation is biological change and associated with puberty girls. It can be easily affected by school environment such as water, latrine with private and dignity, sanitary pad and soap availability. It can be solve by good menstrual hygiene management but stile it is a challenge for schoolgirls due to different factors. However, to improve this school wash facilities were implemented but the result is unknown in Ethiopia especially in Debre Tabor town, Amhara region, Northwest Ethiopia. Objective: Assess menstrual hygiene management practices and associated factors in adolescent girls in schools that have menstrual hygiene management room in Debre Tabor town. Methods: A school-based cross-sectional study was conducted among 712 adolescent schoolgirls in Debre Tabor town. Proportional sample size allocation for each of schools was conducted by using simple random sampling method to select study participants in each class. Data was collected by trained data collectors by using a self-administered structured and pretested questionnaire. The collected data was checked for its completeness, recoded and entered to Epi-info version 7.2 and exported to SPSS version 20.0 for data analysis. Bi variable and multivariable logistic regression were employed with a 95% confidence level. From the bi variable analysis (crude odds ratio [COR]), variables with p<0.25 was used for multivariable analysis (adjusted odds ratio [AOR]). In the multivariable analysis, variables with p<0.05 was taken as statistically significant and independently associated with menstrual hygiene management practice. Result: Near to two-thirds (73.2%) of participants practice good menstrual hygiene and 74.9% of participants had good knowledge. This study found that urban dweller [AOR=1.72, 95%, CI: (1.10, 2.70)], maternal education level secondary school [AOR=2.65,95%,CI:(1.23,5.71) college and above [AOR=1.72, 95%, CI :( 1.09, 2.71)], learn in school about menstrual hygiene [AOR=3.14, 95%, CI :(2.11,4.70)] and sanitary material change in school [AOR=4.18,95%,CI:(2.76,6.32)] were practice good menstrual hygiene management than their counterparts. Conclusion and recommendation: Around two-third of adolescent girls practice good menstrual hygiene, to improve and sustain the schools should take action based on the identified factors. Keywords: Menstrual hygiene, schoolgirls, hygiene factor, menarche, adolescent girls.