ABSTRACT Very little is known about mental health service utilization among Arab and Middle Eastern American (AMEA) college students. We aimed to document AMEA college students’ mental health service utilization behaviors and how known predictors shape this utilization. Using data from the 2015–2020 Healthy Minds Study, we examined self-reported diagnosis of depression or anxiety, lifetime use of therapy/psychotropic medications, and current use of therapy/medications among AMEA and non-AMEA white college students. Survey-weighted logistic regression models were fit with AMEA ethnicity as the main exposure and interaction terms to examine effect modification by religiosity, knowledge, beliefs, and stigma around treatment. Compared to non-AMEA white students, AMEA students had reduced odds of reporting diagnosis of depression (adjusted odds ratio, AOR: 0.84, 95% confidence interval, CI: 0.75, 0.94) or anxiety (AOR: 0.79, 95% CI: 0.71, 0.88), of ever attending therapy (AOR: 0.72, 95% CI: 0.65, 0.79), currently attending therapy (AOR: 0.88, 95% CI: 0.77, 0.99), and receiving medication for a mental health diagnosis (AOR: 0.79, 95% CI: 0.71, 0.88). The relationships between Arab ethnicity and mental health service utilization were modified by religiosity, knowledge, beliefs, and personal stigma about treatment. Better documentation on mental health service utilization in AMEA populations is needed in order to improve prevention efforts and service delivery.