Objectives: Describe the emotional support animal (ESA) experience of college students detailing the process of obtaining an ESA, as well as the benefits and obstacles. Participants: Nine students who had an ESA at college provided preliminary information while an additional four offered insights into their COVID experience with their ESA. Archived records from the Accessibility Resource Center added detail on the ESA process. Methods: This mixed-method study included qualitative interviews (9 students prior to COVID and 4 during COVID) as well as a quantitative analysis of archived data. Thematic analysis was used to extract themes from the interviews. Archived data were analyzed for frequency of select topics. Results: Four positive themes (presence of animal, empowerment, symptom alleviation, and social catalyst) and three negative themes (housing accommodations, lack of ESA education on campus, and social consequences) were extracted from initial interview responses. Analysis of COVID interviews also revealed positive and negative themes with many similar to the pre-COVID responses but also included unique themes reflective of the restrictions imposed by the pandemic. Archived data revealed a substantial increase in the number of ESAs on campus, a wide range of species, and an array of complaints such as safety concerns, ESA behavior, ESA cleanliness, and ESA in unauthorized areas. Conclusions: Overall, the college ESA experience appears beneficial, facilitating the adjustment to college for students with mental health concerns. However, there are drawbacks. Knowledge of obstacles and concerns will help ease the ESA process for all constituents.