This study examined at two Australian university campuses the types of problems that prompt international students to seek counselling services. The concerns reported by ninety students fell within three broad categories; adjustment issues, academic concerns and psychosocial problems. Follow-up interviews with a subset of these students (21) were used to gain more detailed information about their personal adjustment issues and also their experience of counselling services. Counsellors were also interviewed to obtain their perspective on the adjustment and counselling experience of students. Most problems for students occurred within the first 12 months of commencing studies and for many tended to reduce in incidence thereafter, but for some students the issues and problems remained ongoing. While the findings are limited to international students at only two Australian campuses, and furthermore the sample sizes are not large, the results suggest that these students often face extreme adjustment difficulties. Moreover, it is suggested that such students tended to only access counselling services when near the point of collapse, or following academic referral. The importance of pre-departure orientation packages for prospective students, while still in their home country, might reduce the incidence of such adjustment issues.