Objective: To examine human papillomavirus (HPV) vaccine intent and the effect of an educational intervention on vaccine uptake among female college students. Participants: Females aged 18 to 26 attending a university health service gynecology clinic (n = 256). Methods: Participants were randomized to receive either HPV-specific education with a mailed reminder or standard care. Predictors of HPV vaccine intent and uptake at 6 months following enrollment were identified. Results: At baseline, 41% intended to undergo HPV vaccination. Participants who were currently sexually active and lacked supplemental health insurance had decreased intent. Perceived parental approval regarding HPV vaccination, perceived vulnerability to HPV infection, and belief in health benefits of HPV vaccine were associated with increased intent. HPV vaccine uptake was low (5.5%) and did not differ by study group. However, baseline intent was significantly associated with HPV vaccine uptake. Conclusions: Interventions to increase HPV vaccine uptake in college students should address HPV-related beliefs and broader barriers to vaccination. (Contains 4 tables.)