Background Good interpersonal relationships can improve the negative mood and, to a certain extent, may help relieve dysmenorrhea symptoms. However, there has been no study examining the role of interpersonal relationships in dysmenorrhea and how they may interact with negative emotions. Aims To investigate the connection between negative affect and dysmenorrhea, and the role of interpersonal relationships plays in this relationship. Methods The Cox Menstrual Symptom Scale (CMSS), short-form of Depression Anxiety Stress Scale, Interpersonal Comprehensive Diagnostic Scale and UCLA (University of California at Los Angeles) Loneliness Scale were applied to 855 adolescent nursing students to collect information on severity and frequency of dysmenorrheal symptoms, negative emotions (including depression, anxiety and stress), interpersonal problems and subjective experience of loneliness among them, and the relationship among these variables was examined. Results (1) Both the severity and frequency of dysmenorrhea were positively correlated with negative emotions, loneliness experience and interpersonal problems, while negatively correlated with age at menarche. (2) The negative emotions, romantic relationship and menarche age, but not loneliness and interpersonal problems, significantly contributed to both the severity and frequency of dysmenorrhea. (3) Mediation analysis revealed that the effects of loneliness and interpersonal problems on dysmenorrhea were totally mediated by negative emotions. Conclusions This investigation indicates that the relationship between interpersonal relationships and dysmenorrhea is mediated by negative emotions.