Background: People seek complementary health approaches (CHAs) for a variety of health reasons, and high rates of CHA use among U.S. college students have been reported. Purpose: Based on a 2012 study, researchers assessed trends in college CHA use by conducting an updated systematic review of studies published between June 2011-December 2022. Methods: For eight studies that met inclusion/exclusion criteria, weighted means were used to report CHA use, and changes in CHA use between two time points (2012 and 2023) were determined using Chi-square and Pearson's r. Results: Overall CHA use in the past 12 months was 69.7%, and the most commonly used CHAs were NVNM/herbal medicine (55.8%), relaxation techniques (53%), supplements (42.3%), and yoga (37%). Statistically significant (p < 0.01) increases were shown for NVNM/herbal medicine (+25.2%, r = 0.23), yoga (+19.3%, r = 0.19), and meditation (+10.8%, r = 0.10). Use of megavitamins significantly (p < 0.01) decreased by 19% (r = 0.20), compared to 2012 data. Discussion: Future research on college student CHA use needs to be comprehensive and consistent. Translation to Health Education Practice: Certified Health Education Specialists should study and understand trends in CHA use to educate students on the efficacy of CHAs for whole person health.