This study sought to understand the utilization rates and presenting concerns of international students in order to identify relevant topics for outreach programming. We examined the presenting concerns of all international students (n= 41) who sought counseling at a university counseling center during an academic year. The results indicated that only about 2% of the international student body sought counseling services from the counseling center that year. Results also showed that most of the international students who sought counseling presented with concerns about depression, assertiveness, academic major, and anxiety, and that about a third dropped out after the initial intake session. Implications for outreach programming with international students are addressed. (Contains 1 table.)