Objectives: In this study we examined patterns of transition in posttraumatic stress disorder (PTSD) symptoms over the 1st year of college. We also examined 2 factors that might predict these transitions: trauma exposure and alcohol involvement. Method: Matriculating students (N = 944; 65% female) completed assessments of PTSD, trauma exposure, and alcohol use and consequences multiple times in their freshman year. Three symptom classes (no symptoms, moderate symptoms, and severe symptoms) were identified. Examination of transitions from 1 status to another was conducted with latent transition analysis. Results: These models revealed considerable variability in the course of PTSD symptoms. The most common pattern was resolution, yet a significant portion of students showed other patterns. Symptom worsening was more commonly observed in the 2nd semester. Trauma exposure had a deleterious effect on PTSD symptom change trajectories, as did alcohol involvement, though less consistently so. Conclusions: Interventions that focus on the timing and correlates of symptom progression may benefit college students with posttraumatic distress.