The authors describe the initiation and use of a Web-based triage system in a college health setting. During the first 4 months of implementation, the system recorded 1,290 encounters. More women accessed the system (70%); the average age was 21.8 years. The Web-based triage system advised the majority of students to seek care within 24 hours; however, it recommended self-care management in 22.7% of encounters. Sore throat was the most frequent chief complaint (14.2%). A subset of 59 students received treatment at student health services after requesting an appointment via e-mail. The authors used kappa statistics to compare congruence between chief complaint and 24/7 WebMed classification (kappa = 0.94), between chief complaint and student health center diagnosis (kappa = 0.91), and between 24/7 WebMed classification and student health center diagnosis (kappa = 0.89). Initial evaluation showed high use and good accuracy of Web-based triage. This service provides education and advice to students about their health care concerns. (Contains 5 tables.)