Background: The purpose of this study was to examine the experience, knowledge, and needs of school counselors in relation to students' self-injurious behaviors. Methods: One thousand members of the American School Counselor Association were randomly selected to receive a questionnaire on the study of self-injury. Four hundred forty-three school counselors returned usable questionnaires. Results: Most (81%) reported working with a self-injurer during their career, and 51% reported working with a self-injurer during the 2002-2003 school year. Findings suggest that counselors feel they are the appropriate person to work with students who self-injure but need more training to identify self-injurers and refer them to appropriate resources outside of the school. Counselors identified a number of barriers to successfully working with students who self-injure, such as lack of training, lack of cooperation with school personnel, and lack of policy on school injury. Conclusions: The authors suggest a model where the school counselor acts as a liaison to ensure the coordination of education about self-injury for students, parents, and school staff and as a conduit to refer students to therapists in the community.