Objective: To examine prospective associations between physical and mental self-rated health (SRH), college generation status and college adjustment among first-year college students. Participants and methods: Eighty-seven first-year college students (41 first-generation college students) reported their SRH when starting college, and then, reported on psychosocial and academic adjustment and health behaviors midway through each semester. Results: Better physical and mental SRH were associated with better psychosocial adjustment in both semesters and academic adjustment in the fall but were generally not predictive of health behaviors. Specifically, better physical SRH was associated with less loneliness (fall: B = -0.192, p = 0.048; spring: B = -0.233, p = 0.008) and fewer anxiety symptoms in both semesters (fall: B = -0.236, p = 0.011; spring: B = -0.210, p = 0.014) and fewer depressive symptoms (fall: B = -0.134, p = 0.016) and more fall semester credits (B = 0.965, p = 0.002). Better mental SRH was associated with greater sense of belonging (fall: B = 0.317, p < 0.001; spring: B = 0.242, p = 0.009), less loneliness (fall: -0.210, p = 0.008; spring: B = -0.181, p = 0.012), and fewer anxiety symptoms (fall: -0.193, p = 0.011; spring: -0.195, p = 0.006) in both semesters and higher fall semester grade point average (B = 0.129, p = 0.032). Independent effects of physical and mental SRH are also discussed. Largely, college generation status did not matter for college adjustment within this sample. Conclusions: Physical and mental SRH when starting college may be important indicators of psychosocial adjustment over the first year and academic adjustment in the fall.