Primary dysmenorrhoea (PD) is the most common gynaecological condition among young women and is associated with significant socioeconomic repercussions. It is unclear which works best for pain relief when pharmacological and non-pharmacological interventions are compared. This systematic review and network meta-analysis (NMA) will aim to compare and rank the effects of pharmacological and non-pharmacological interventions in patients with PD.Randomised controlled trials of pharmacological and non-pharmacological interventions for PD will be identified via a search of the PubMed, Cochrane Library, Web of Science, Embase, Scopus database and Google Scholar search engine until September 2025. The primary outcome will be a change in pain intensity among patients with PD, while the secondary outcomes include health-related quality of life, symptoms of depression and anxiety, and treatment-related adverse events. Two independent reviewers will perform document screening, study selection and data extraction. The methodological quality of the included studies will be assessed using the Cochrane Risk of Bias tool (V.2). The RevMan, Stata and Aggregate Data Drug Information System software will be used to perform a pairwise meta-analysis and Bayesian NMA in a random-effects model. The certainty of the evidence will be rated using the Grading of Recommendations, Assessment, Development, and Evaluation System.This systematic review protocol is exempt from ethical approval as it involves analysis of previously published data. The findings of this review will be submitted to peer-reviewed journals.CRD42024543573.© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.