The provision of toilets and menstrual supplies appears to be a promising strategy to promote adolescent girls’ school attendance and performance in less developed countries. In this article, we use the first round of the Malawi Schooling and Adolescent Survey (MSAS) to examine the individual- and school-level factors associated with menstruation-related school absenteeism. Although one-third of female students reported missing at least 1 day of school during their previous menstrual period, our data suggest that menstruation accounts only for a small proportion of all female absenteeism and does not create a gender gap in absenteeism. We find no evidence for school-level variance in menstruation-related absenteeism, suggesting that absenteeism due to menstruation is not sensitive to school environments. Rather, coresidence with a grandmother and spending time on schoolwork at home are associated with lower odds of absence during the last menstrual period.