Aim: To evaluate and compare the serum magnesium and calcium levels in students with premenstrual distress with those of normal students. Methodology: The present study was conducted at Gandhi Medical College, Telangana, India. Fifty medical and paramedical students of age 18-24years with regular cycles were included in the study and were given the PMS diagnostic questionnaire developed by the University of California, San Diego recommended by the American College of Obstetrics and Gynecology. Students showing premenstrual symptoms were considered as Study group (25) and those without symptoms as controls (25). 5ml of fasting venous blood samples were collected from both groups between the 15th -28thday (luteal phase) of the menstrual cycle. These samples were tested using Beckman Coulter for serum calcium and magnesium levels. Comparison between the groups was done by student’s t-test and a p-value<0.05 was considered significant. Results: Significant lower values for serum magnesium levels were observed in study group compared to controls. The prevalence of magnesium deficiency was significant in the study group. Conclusion: Low magnesium levels are probably an important cause of premenstrual distress. Based on serum values, more than half of students with premenstrual distress were found to be deficient in magnesium.