Purpose: This study developed and evaluated an adventure-based cognitive behavioral intervention (aCBI) program to respond to the higher education mental health crisis in Hong Kong. Methods: The aCBI program was delivered in the form of a 13-week general education (GE) course and was evaluated at pre-, post-, and 3-month follow-up. A total of 544 undergraduate students who experienced psychological distress were randomized to either the aCBI group (n = 197) or the wait-list control group (WLC) (n = 347). Results: Compared with their WLC counterparts, the aCBI participants showed significantly stronger improvements in psychological distress, perceived stress, positive and negative emotions, and resilience at the posttest and 3-month follow-up. Positive and negative thoughts and sense-making coping partially mediated the treatment effects of aCBI. Conclusions: The aCBI program shows promise for inclusion in higher education curriculums to bridge the mental health service gaps for Chinese university students.