OBJECTIVE To determine the psychosocial correlates of emotional responses to menarche among Chinese adolescent girls. METHODS A large sample of 1573 post-menarcheal Chinese junior high school students in Hong Kong completed questionnaires on knowledge and preparation of menarche, attitudes toward menstruation, gender-role attitudes, body image, self-esteem, and emotional responses to the onset of the first menstruation. Pearson correlation and hierarchical regression analyses were conducted to determine associations among variables. RESULTS Participants' mean age at menarche was 11.67 years. Their emotional reactions to menarche were largely negative, with almost 85% reporting feeling annoyed and embarrassed. In spite of these negative feelings, about two-thirds of the participants also reported feeling grown up and another 40% felt as if becoming more feminine. Results of the hierarchical regression analyses showed that negative emotional responses to menarche were correlated with perceptions of menstruation as a negative event, inadequate preparation for menarche, endorsement of indigenous negative menstrual attitudes, and poor self-esteem (24.5% variance explained). Positive emotional responses to menarche were correlated with perceptions of menstruation as a natural event, rejection of indigenous negative menstrual attitudes, positive body image, and adequate preparation for menarche (13.4% variance explained). CONCLUSIONS This study illustrates the need to attend to various psychosocial and cultural factors in the understanding of Chinese adolescent girls' responses to their first menstruation. In particular, general and indigenous menstrual attitudes, which may have been internalized by Chinese adolescent girls at an early age, are found to be the most salient correlates of their emotional responses to menarche.