This is the first study to empirically identify distinct acculturative adjustment patterns of new international students over their first 3 semesters in the United States. The sample consisted of 507 Chinese international students studying in the United States. Using psychological distress as an indicator of acculturative adjustment, measured over 4 time points (prearrival, first semester, second semester, and third semester), 4 distinct groups of student adjustment trajectories emerged: (a) a group exhibiting high levels of psychological distress across each time point (consistently distressed; 10%), (b) a group with decreasing psychological distress scores from Time 1 to Time 2 (relieved; 14%), (c), those with a sharp peak in psychological distress at Time 2 and Time 3 (culture-shocked; 11%), and (d) a group with relatively consistent low psychological distress scores (well-adjusted; 65%). Moreover, significant predictors of a better acculturative adjustment pattern included having higher self-esteem, positive problem-solving appraisal, and lower maladaptive perfectionism prior to the acculturation process. In addition, during the first semester of studying in the United States, having a balanced array of social support and using acceptance, reframing, and striving as coping strategies were associated with a better cross-cultural transition. Practical implications and future directions were also discussed. (Contains 1 figure and 3 tables.)