Objective: To describe the use of psychiatric medication and related health service utilization among college students receiving care on- and off-campus. Participants and methods: 3959 students from a large southern university participated in the Healthy Minds Study in May 2018. Results: Of students surveyed, 17.6% took psychiatric medication in the last year. Of these students, 22.0% received prescriptions on-campus, 61.7% received prescriptions off-campus, 6.4% received them both on- and off-campus, and 9.9% took medication without a prescription. Nonwhite, international, and younger students were more likely to utilize on-campus rather than off-campus psychiatric medication services (p < 0.05). Satisfaction with health services did not differ by location. Conclusions: The majority of students received psychiatric prescriptions off- rather than on-campus. While satisfaction with both on- and off-campus health services is equally high, minority, international, and younger students are more likely to seek care on- rather than off-campus.