Menstrual health literacy is essential for female students’ wellbeing, reproductive health, dignity, and academic participation. Despite increasing awareness, knowledge gaps and suboptimal menstrual hygiene practices remain among young women in higher institutions. This study assessed menstrual health knowledge and hygiene practices among female students of Rivers State College of Health Science and Management Technology, Port Harcourt, Nigeria. A descriptive cross-sectional survey design was adopted. The study population comprised female students aged 16–40 years who had attained menarche. Using Taro Yamane’s formula, a minimum sample size of 348 was obtained, while 340 valid questionnaires were analyzed. Data were collected using a structured self-administered questionnaire and analyzed with frequencies, percentages, means, and standard deviations. Most respondents were aged 16–24 years (50.0%), single (87.6%), Christian (97.1%), and in their first or second year of study (73.4%). Respondents demonstrated a high level of menstrual-cycle knowledge, with mean scores exceeding the 3.50 decision threshold for awareness of menstruation, cycle interval, menstrual-flow duration, quantity of flow, and ovulation timing. Menstrual hygiene practices were also generally satisfactory, particularly regarding self-care, pad-changing frequency, use of sanitary materials, vulva cleaning, and handwashing after pad changes. However, variations in some hygiene practices indicate that adequate knowledge does not always translate into optimal behavior. The study concludes that while menstrual health literacy among female students is generally high, sustained health education, strengthened campus health services, improved sanitation facilities, and affordable menstrual products are needed to reinforce positive practices and improve menstrual health management in tertiary institutions.