In the university academic atmosphere, guidance and counseling practices are an efficient and effective way of supporting and helping students deal with problems and issues in educational, career, and personal/social areas. This study aimed to assess the magnitude, perceived need, and associated factors to counseling services of students in Dilla University, Southern Ethiopia. A mixed-study design was employed with both quantitative and qualitative research approaches. Both primary and secondary sources of data were employed. Data collection tools are questionnaires, focus group discussions, and in-depth interviews. The collected data were coded, entered, and analyzed using SPSS version 20 software. Quantitative data were presented as mean, percentage, frequency, and cross-tabulation. The qualitative data were analyzed and interpreted thematically, and the results are presented in narrative form. The finding of the study shows that there are a high number of students who need guidance and counseling at Dilla University from different colleges and departments. The student’s age level, sex, parental marital nature, the department they joined, family economy, occupation, and residence are the main factors that affect positively or negatively their counseling needs in higher education. The identified highest personal counseling needs and indicators in Dilla University students are for maintaining good physical and mental health, handling stress and anxiety in their life, solving personal problems, overcoming procrastination, dealing with stress due to their job, and coping with a broken relationship. The items that were indicated as having the lowest prevalence for concerns in terms of personal needs required by students were concerns about learning how to manage drug addiction, to become overcome insomnia, and reproductive health problems are the lowest need reported by participants of the study. This needs all stakeholders’ attention and support on the issues of guidance and counseling at Dilla University.