Identifying factors influencing career counseling services and providing interventions to increase utilization is crucial because only a few individuals facing career problems use these services. Utilizing the moderated mediation effect of career decision-making autonomy on the mediated model of self-concealment, career stress, and attitudes toward career counseling, this study analyzed 307 college students in South Korea. This study investigated whether career stress mediates the relationship between self-concealment and attitudes toward career counseling. Additionally, it examined whether career decision-making autonomy moderates this mediated model. The results suggest that career decision-making autonomy is crucial in seeking career counseling services to cope with stress. Implications for further research, limitations of this study, and interventions for increasing using career counseling are discussed.