The agenda on menstrual hygiene management (MHM) in schools requires and is beginning to receive growing attention at global, national and local levels. In the last ten years, a growing body of mostly qualitative evidence has documented the numerous barriers that schoolgirls face in low- and middle-income countries when managing menstruation in school environments. These range from a lack of guidance and support in learning about menstruation, lack of adequate, safe, clean toilets, insufficient availability of water inside or near the toilet, inadequate disposal systems for used sanitary materials (when sanitary materials and underwear are even available), and numerous health issues. Understanding the evidence on MHM in schools is essential to identifying scale-able, cost-effective solutions. The solutions to addressing the MHM challenges faced by schoolgirls (and female teachers) require cross-sectoral engagement that includes water and sanitation, education, health and gender researchers, practitioners and policy makers. There are growing examples of global, national and local approaches to addressing the MHM challenges faced by schoolgirls. These illustratively include the development and dissemination of country-specific girl’s puberty books which include content on MHM, the annual virtual MHM in WASH in Schools Conference co-hosted by UNICEF and Columbia University, the development of MHM guidelines for schools, and new randomized trials underway to examine the effectiveness of various interventions. More evidence and action are needed to meet by 2024 the priorities identified for the ten-year agenda for MHM in schools.