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International student enrollment in U.S. higher education has been increasing, but little attention is paid to understanding the mental health needs of international students to support their transition, adjustment, and development in college. International students with disabilities may face more challenges on top of common barriers reported in the literature. However, no prior research has examined the mental health needs of international students with disabilities. This study examined the psychological distress and suicidal ideation experienced by international students with disabilities who sought treatment in college counseling centers. The results indicated that students with disabilities are more likely to report higher psychological distress and suicidal ideation. Additionally, family and social support are negatively associated with psychological distress and suicidal ideation.