Objective and Participants: The authors examined the prevalence of mental health needs in international graduate students, their knowledge of mental health services, and their use of on-campus and off-campus counseling services. Methods: All registered graduate students in the Spring 2004 semester received an e-mail invitation to participate in a Web survey. Of the 3,121 completed surveys, 551 completed surveys were from international graduate students. Results: Approximately 44% of international graduate students responded that they had had an emotional or stress-related problem that significantly affected their well-being or academic performance within the past year. International students who reported a more functional relationship with their advisors were less likely to report having an emotional or stress-related problem in the past year and using counseling services. International students who reported higher financial confidence were also less likely to use counseling services. Conclusions: There is an unmet mental health need among international graduate students. Special mental health outreach efforts should be directed at international graduate students, with particular attention on the relationship between students and their advisors and on adequate financial support for students. (Contains 5 tables.)