Social determinants of health (SDOH) are living conditions that influence mental and physical health. The American School Counselor Association provides school counselors with guidance for addressing SDOH, and this study sought to explore school counselors' experiences in doing so. Using qualitative methodology, specifically, consensual qualitative research, with 11 school counselors, we identified six domains that describe school counselors' experiences and perceptions of addressing SDOH with students and families. Ecological Social Justice School Counseling theory informed the discussion and implications for school counselors and school counselor educators.