Purpose: Supporting the mental health of university students is a key priority for higher education. Students living with long-term health conditions are at increased risk of poor mental health; yet little work has focused on their particular mental health needs or indeed, the implications for health education in the university setting. This study sought to identify the mental health support needs of students with long-term conditions, including best ways for universities to support these students. Design/methodology/approach: A UK national online survey of 200 university students living with long-term physical health conditions (e.g. asthma, endometriosis, epilepsy) was conducted in 2019. Findings: 95% of respondents reported that their long-term condition/s had at least a moderate impact on their mental wellbeing, with 81% reporting that they felt depressed and anxious at least once a month because of their health. The most common suggestion for how universities can better support their mental wellbeing was to raise awareness about long-term conditions on campuses, with many reporting a lack of understanding about long-term conditions from academic and support services staff members -- with negative impacts on their mental health. Because of this, some respondents reported a reluctance to come forward and seek help from university services, with 25% not formally disclosing their conditions. Originality/value: These reported concerns underscore the need to develop health education amongst university staff about long-term conditions and to ensure these students are supported with their health at university.