Objective: Research has demonstrated that providing appropriate supports and services on campus can improve both mental health and academic outcomes for students with disabilities (Emerson, Honey, Madden, & Llewellyn, 2009; Stumbo, Martin, & Hedrick, 2009), but little is known about the specific mental health needs of this population. The purpose of this exploratory study, therefore, was to identify the mental health needs of college students with various types of disabilities. Method: Researchers analyzed data, collected by the Center for Collegiate Mental Health, of 5,696 students with, and without, disabilities who utilized counseling services on campuses in the 2013-14 academic year. A nonclinical (students not in counseling) sample of 1,620 students with, and without, disabilities was also explored. Results: Compared to students without disabilities, students with disabilities report more anxiety and academic-related distress, as well as higher rates of suicide ideation, suicide attempts, and nonsuicidal self-injury among both students in counseling and not in counseling. Conclusions: Although in certain areas students with disabilities show similar levels of distress as students without disabilities, students with disabilities have higher levels of distress in areas which could impact their academic success. Self-harming tendencies are higher for students with disabilities overall, but more so for specific disability types. Impact and Implications The current study is the first to examine mental health similarities and differences among students with and without disabilities in both the general campus population (i.e., a nonclinical sample) and students receiving counseling (i.e., a clinical sample). The study revealed that students with disabilities, in both clinical and nonclinical samples, had higher rates of suicide ideation, suicide attempts, and nonsuicidal self-injury, as well as more anxiety and academic distress. Outreach and education should be provided to college and university staff who have regular interaction with students with disabilities due to the relationship between students with disabilities and higher rates of self-harming thoughts and behaviors.