International students in higher education represent a diverse population with unique mental health needs. Foreign students commonly experience a host of adjustment issues, including acculturative stress, language difficulties, cultural misunderstandings, racial discrimination, and loss of social support. Despite their challenges, few international students seek individual counseling. The purpose of this article is to present counseling groups as a treatment modality for addressing international students' adjustment concerns. Special attention is directed to the practical, ethical, and cultural challenges of conducting group counseling with this population, in addition to presenting recommendations for future practice and research.