Background: The menstrual cycle in women is characterized by high variability in cycle length with variable associated physiological and psychological changes along different phases. The premenstrual period was associated with a rise in negative psychological symptoms like anxiety, depression and fatigue. Mood and behavioral changes such as irritability, stress, mood fluctuations, exhaustion, and food cravings are all signs of premenstrual syndrome (PMS) that occur within a few days of menstruation during the luteal process. Objective: The main objective of this study is to highlight the role of menstrual cycle phase in anxiety among Saudi women. Methods: A community based cross-sectional study was conducted in different regions of Saudi Arabia from the period of 1 September to 30 November 2020. Data was compiled and analyzed using statistical package for the social sciences (SPSS, version 16) and results were analyzed with frequencies and Chi-squared test as appropriate. P value was considered significant if <0.05. Results: 56.4% of women suffer from anxiety before or during menstruation. 70.6% of women reported anxiety before menstruation, 27.8% during menstruation and only 16% after menstruation. 42.1% reported anxiety every month, 46.6% reported prevention of menses due to anxiety and 23.7% reported that anxiety affects duration of menses. 47.3% feel depressed before menstruation, 14% have panic attacks during menses and 38.4% reported sleeping disturbance during menstruation. Conclusion: Anxiety and stress adversely affects the menstrual cycle. There was a significant correlation between anxiety and duration of the menstrual cycle, severity of bleeding and menstruation prevention Health professionals should facilitate good self-care to increase the quality of life of women of reproductive age. Key Words: menstrual cycle and anxiety, anxiety effect on menstruation, menstruation irregularity and its association with anxiety