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Students with disabilities are a growing population on college campuses and have unique challenges that put them at risk for early departure, creating complexity in efforts to address their personal and academic needs. Purpose: The purpose was to explore academic and other sources of distress among college students with disabilities to identify possible areas where enhanced supports might benefit this population. Research Method and Design: Researchers analyzed cross-sectional data from the Center for Collegiate Mental Health to compare subsamples of students with (n = 1,774) and without disabilities (n = 1,774) on presenting concerns, and to determine significant predictors of academic distress among students with disabilities. Results: Results indicated that students with disabilities have many similar treatment concerns with their peers, but showed greater concerns in depression and self-harm; academic performance; anxiety and obsessions/compulsions; and fewer concerns in relationship problems. Significant predictors of academic distress for students with disabilities included attention deficit-hyperactivity disorder (ADHD), depression and self-harm, trauma or victimization, stress and academic performance, and social support from family and peers. Conclusions/Implications: These results suggest the importance of several factors in understanding the presenting concerns of treatment-seeking students with disabilities and mitigating academic distress for this population. Additional areas for research are presented.