Psychotherapy with college students and young adults is an important and dynamic niche practice option for mental health professionals. Young adults are navigating crucial human development tasks, and the range of mental health services they often require as they do so is varied and dynamic. Mental health professionals who choose to specialize with the college and young adult population can expect a steady stream of clients in need of services, and with appropriate training and marketing, it is possible to build a busy, successful practice around this clientele. This chapter describes the niche practice area of college and young adult mental health, the author’s history in training and working with this population, and the business and ethical challenges associated with a practice in young adult mental health. Guidance in developing a young adult mental health specialty niche and resources for doing so are also included.