Objective There are well-documented health disparities among sexual and/or gender minority (LGBTQ+) individuals generally, but there is limited research investigating the disparities in health-related lifestyle factors and mental health among LGBTQ+ graduate students, which is a group that may be especially vulnerable. Participants This project was a secondary analysis of data from the American College Health Association’s National College Health Assessment’s (NCHA) Fall 2019 wave, which included 7,766 graduate students. Methods Students self-reported engagement in health-related lifestyle factors and psychological distress. Welch’s independent samples t-tests were used to compare differences in psychological distress and lifestyle behaviors and multiple linear regression models were used to test lifestyle factors as predictors of LGBTQ+ psychological distress. Results LGBTQ+ graduate students reported worse lifestyle profiles compared to their peers and greater psychological distress. Sleep quality had the strongest association with psychological distress among LGBTQ+ graduate students. Conclusions These findings have important implications for policies and interventions to improve health and decrease suffering in LGBTQ+ graduate students.