The authors conducted a study of 5,472 university students to identify the prevalence and predictors of religious and spiritual concerns. Approximately 25% of the sample reported considerable distress related to such concerns. Logistic regression analyses revealed that students with considerable distress related to religious or spiritual concerns also tended to be distressed about the loss of a relationship, sexual assault, confusion about values, homesickness, and suicidal ideation. These students were especially likely to seek psychological help when they also had problematic relationships with peers. Among all students who sought help, considerable distress about religious or spiritual concerns was predicted by confusion about values, problematic relationships with peers, sexual concerns, and thoughts of being punished for one's sins.