This study examined student access to school counselors and the link between school counselor-to-student (SC-S) ratios and student outcomes in six states in the United States. Access to school counselors was often greater for White students, but less for Asian students, English learners, or those in larger schools. In the two states with the lowest SC-S ratios among the states studied, schools with more counselors per student (a) had higher English SAT scores and more students with postsecondary enrollment (i.e., New Hampshire), and (b) had more students enrolled in postsecondary studies (i.e., Maine). In the two states with the highest SC-S ratios of the six studied, schools with more counselors per student (a) had lower overall learning outcomes and graduation rates (i.e., Arizona), and (b) had worse academic outcomes in English, math, or science (i.e., Idaho). Schools with higher SC-S ratios showed more suspensions (i.e., New Hampshire) and more chronic absenteeism (i.e., Arizona, Missouri, and Rhode Island). We discuss implications for legislative advocacy, intentional school counselor caseload assignments, and future research.