© 2022 Elsevier LtdBackground: In the literature, it is thought that spine or pelvic malalignment and changes in the abdominal muscle structure may affect the uterine position and cause menstrual pain. However, the overall lumbopelvic structure related to lumbopelvic muscle endurance, thickness, alignment, and mobility in women with primary dysmenorrhea has not been well investigated. This study aimed to compare women with primary dysmenorrhea and asymptomatic controls in terms of lumbopelvic structure. Methods: Women with primary dysmenorrhea (primary dysmenorrhea group, n: 38, age: 21 years (18–28), body mass index (BMI): 20.70 (17.31–28.73) kg/m2) and without primary dysmenorrhea (asymptomatic group, n: 39, age: 20 years (19–23), BMI: 20.83 (17.31–27.10) kg/m2) were included. The severity of menstrual pain, lumbopelvic muscle endurance, morphology, alignment, and mobility were assessed with the Visual Analogue Scale, McGill trunk muscle endurance tests, ultrasonographic imaging, and a Valedo® Shape device, respectively. Findings: The median value of the menstrual pain in the primary dysmenorrhea group was 6.5 cm (min-max: 4.0–10.0). Lumbopelvic muscle endurance (p < 0.001), muscle thickness (p < 0.001), frontal lumbar angle (p: 0.05), sagittal pelvic mobility (p < 0.001), and frontal lumbar mobility (p: 0.002) were lower in the primary dysmenorrhea group compared to the asymptomatic group. Interpretation: Muscle endurance, thickness, alignment, and mobility of the lumbopelvic structure in women with primary dysmenorrhea compared to asymptomatic women have been affected negatively. These findings should be considered in management of primary dysmenorrhea.