This study informs the limited findings on student-athlete mental health by comparing student-athletes and nonathletes receiving psychological services at University Counseling Centers (UCCs) on (a) UCC utilization rates, (b) clinical presentations and historical treatment experience, and (c) treatment outcomes. Method: Using naturalistic data from a large practice-research network (PRN) spanning 2017-2019, the following analyses were conducted: paired t-tests to examine UCC utilization rates in aggregate and by athletic division (Aim 1; UCC N = 104 & 110); Nested multivariate analysis of variance (MANOVA) and logistic regression to compare presenting symptomatology and historical treatment experiences (Aim 2; N = 7,730); and Nested Residualized MANOVA and Univariate Nested analysis of variance (ANOVAs) to assess pre-to post-treatment symptom changes (Aim 3; N = 2,563) within and between student-athletes and nonathletes. Results: Compared to nonathletes, student-athletes utilized UCC services at slightly lower rates (i.e., small to moderate effect sizes) overall, though they use services at equal or greater rates within Division I institutions; tended to present with lower levels of distress across several psychological domains; and benefitted equally or more from treatment, particularly in areas of depression, generalized and social anxiety. Conclusions: Study findings provide unique insight on the experiences of treatment-seeking student-athletes by demonstrating a significant, positive responsiveness to treatment, as well as novel comparisons between student-athletes and nonathletes receiving services within UCC settings.