Objective: Examine associations between care seeking reasons in college health and counseling centers and sexual violence (SV). Participants: College students (n = 2,084 baseline, n = 1,170 one-year follow up) participating in a cluster randomized controlled trial of an SV reduction intervention on 28 campuses. Methods: Computer-based survey data gathered during students' clinic visit and one-year follow up. Results: Despite high prevalence of SV, students almost never sought care specifically for SV (0.5% of reported visits). Gender differences emerged for reasons students sought care generally, but were not associated with differences in care seeking among those who experienced SV. At baseline and one-year, students who reported SV were more likely to state mental or sexual and reproductive health as their reason for care seeking. Conclusion: Many students seeking care have experienced SV yet present with other health needs. Providers need to recognize this and have a low threshold for providing SV resources routinely. Supplemental data for this article can be accessed online at https://bibliotheek.ehb.be:2102/10.1080/07448481.2022.2057189