Many college students are insufficiently physically active, and health care practitioner consultations represent an opportunity to provide at risk students with physical activity counseling (PAC). This study examined whether any demographic or physiological variables differentiated those who had received PAC and those who did not. An objective fitness assessment and survey collected data from college students concerning the following: demographics; body composition; aerobic fitness; cholesterol, lipid, and glucose levels; muscular endurance; physical activity (PA) levels; health care and PAC; PA information sources; and depression. Parametric and nonparametric techniques were used to examine differences between those who did and did not receive PAC, by location of counseling, and between those who did and did not report depressive symptoms. Rates of PAC were high, with only total cholesterol differentiating those who did and did not receive PAC. Study design prevented the determination of whether students or health care providers initiated PAC and what form of PAC was provided. Vigorous PA was significantly lower among those who reported mental health–related symptoms. Findings suggest a lack of targeted PAC among the least active, least fit, or most overweight/obese. Further investigation is warranted on the use of PAC at campus health services. In particular, the initiation of PAC, the PAC techniques/strategies used by physicians, and the short- and long-term effectiveness of PAC on PA and associated health outcomes. Barriers to student health care center physicians providing PAC also require further investigation, as does the effectiveness of any PAC and any support provided by physical fitness professionals that students may be referred to in both the short and long term.