Introduction: Food craving was one of the common symptoms of premenstrual syndrome (PMS) among women. This study aimed to examine level of food craving during pre-menstruation and PMS symptoms; its association and predictor of PMS symptoms on food craving during pre-menstruation among university students. Methods: A cross-sectional study was conducted among female undergraduate students from International Islamic University Malaysia, Kuantan Campus. Screening phase for eligibility was conducted. Three questionnaires consisted of Health History Questionnaire, Food Craving Questionnaire-Trait-reduced and Premenstrual Tension Syndrome Rating Scale were distributed among eligible students. Descriptive analysis, Pearson correlation test and multiple linear regression were performed using SPSS version 22.0. P value was set at p<0.05 as statistically significant. Results: 129 students were eligible as study respondents. A total of 48% of the respondents showed clinically relevant traits of food craving. The highest food craving among respondents were sweet foods (45.7%) followed by fatty (18.6%), spicy (10.9%), salty (8.5%) and sour (2.3%) food. 60% respondents had moderate to severe PMS symptoms level. There was a significant association between food craving and PMS symptoms (p=0.001). PMS symptoms significantly predicted food craving (p=0.002). Conclusion: This study is at the forefront in reporting food craving and PMS symptoms among undergraduate students which were prevalent during pre-menstruation. Food craving was significantly associated with PMS symptoms. This research provides further insight related to food craving among women particularly the role of PMS symptoms as predictor. Strategies in preventing substantial calories intake during pre-menstruation is therefore required in this population.