Background: Peer education has the potential to promote health behaviors and cultural competence for both international and domestic college students. Purpose: The present study examined a peer education program aimed at promoting cultural competence and health behaviors among international and American students in a university setting. Methods: Thirty-six international and 36 domestic students were recruited and matched in March 2013. Peer pairs met twice a week for 6 weeks. The meetings included tutoring, discussion, counseling, and activities. Results: Significant intervention effects were observed for all variables except nutrition knowledge, physical activity practice, and stress management practice. The intervention effects were different between the American and the international students on nutrition practice, smoking cessation practice, knowledge of stress management, and cultural concepts and cultural patterns. Discussion: Peer education appears to be a promising method for promoting health behavior as well as cultural competence among international and American college students. Translation to Health Education Practice: This model may extend to other health behavior or health promotion-related courses that employ service learning or praxis instructional approaches, as well as institutions that offer existing programs for international students.