This paper reviews research on students' usage of university counselling services across countries and their demographic and psychological characteristics. In doing so, emphasis is given to reported distinctions between local and international university students. Utilisation rates, encouraging factors and barriers to utilisation, presenting problems, and methodological problems with existing studies are each examined. The findings suggest that only a minority of between 2% and 4% of university students access such services, with females being more likely to use them than males. International students in particular underutilise these services, and this is primarily due to such students' preference for seeking help from family or friends over outside sources. When students do seek assistance, their presenting issues most commonly involve symptoms of depression or anxiety, as well as academic and relationship difficulties.