Background: Student substance abuse is a serious concern for middle school personnel. School counselors are most likely to deliver mental health services, including substance abuse, in school settings. However, limited research is available on the perceived competence of middle school counselors for addressing student substance abuse concerns. The main purpose of this study was to determine how middle school counselors perceive their training in 9 competence areas related to student substance abuse. A secondary aim of this study was to identify which training areas counselors indicate as being most needed to address student substance abuse. Methods: A survey study was conducted that included a national sample of 283 middle school counselors. Analysis of variance was used to determine differences between 9 competency areas rated by counselors. Further analysis was conducted to determine which training areas were most important to counselors. Results: Counselors varied in their perceived competence depending on the specific area of student substance abuse; however, they were clearly able to identify the most important areas of training needed. Conclusions: Overall, the findings from this study indicate that middle school counselors require more training in the area of student substance abuse. Specifically, this study provides information on the most important areas of training as identified by counselors. (Contains 2 figures and 1 table.)