Music students in tertiary education struggle with a range of health-related problems. We investigated students' self-referrals for counseling at a UK conservatoire to explore trends in students' attendance at counseling sessions over time and identify their reasons for seeking and continuing to attend counseling. We conducted a secondary analysis of data collected from 645 students by two in-house counselors at the conservatoire between 2000 and 2016. We obtained analogous data on all students registered during the same period for comparison and conducted nonparametric tests of association between the groups. A total of 645 students attended a mean of eight (Mdn = 4) counseling sessions over the 16-year period: 63% were female, 79% were from the UK, and 72.5% were undergraduate students. The percentages of students attending counseling increased from 2 (1%) in 2000-2001 to 71 (13%) in 2015-2016. The presenting concerns of almost one in 10 students who sought counseling were related to self-esteem, self-confidence, ego strength, and coping ability. Their main reasons for continuing to attend counseling were also to do with self and identity, relationships, academic concerns, loss, abuse, and anxiety. Female students, postgraduate students, and those studying singing were most likely to attend counseling sessions.