While college campuses are relatively safe environments, the promise of safety and security on campus was shattered by a single gunman on April 16, 2007. Seung-Hui Cho, a senior at Virginia Tech, shot 49 students and faculty, killing 32, before killing himself. The authors are psychologists and directors of university counseling centers; they examine the many implications of this tragedy on mental health counseling. The assailant's significant psychological disturbances and previous contact with mental health professionals are critical to understanding how he was able to act out his murderous rage. The mental health response to a traumatized community of families, friends, colleagues, and peers is reviewed. Out of the tragedy, there have emerged many issues that challenge the role of counseling centers within the university including the development of threat assessment teams, the potential conflicts between client confidentiality and crisis prevention/management, and the on-going education for the university community regarding suicide prevention, mental illness and support for potentially marginalized students.