Despite the high prevalence of and documented impairment associated with pediatric anxiety disorders, less than half of youth access mental health services. This study examined: (1) the utilization of eight school services and supports (e.g., seen a school counselor for a mental health reason, placement in a special class for a behavior or emotional difficulty); and (2) demographic (gender, age) child clinical (anxiety severity and impairment) and family (parent psychopathology, caregiver strain) predictors of service utilization. Participants included 208 anxious youth between ages 6 to 18 years (M = 10.92, SD = 3.29, 51% male, 64% White) who were enrolled in a school-based randomized controlled trial for anxiety treatment; only baseline data were used for this study. Parents, children, teachers and independent evaluators completed measures of the above predictors. Results indicated that less than half (48%) of youth received school services for anxiety. Several predictors of higher total service utilization were identified. Youth with comorbid externalizing behaviors were more likely to be referred for and receive school-based services. Consistent with published data in community samples, less than half of anxious youth received needed services. Results suggest a need for improvements in school assessments and service referral mechanisms for students with anxiety. [This is the online version of an article published in "Journal of Emotional and Behavioral Disorders."]