OBJECTIVE : The objective of this study was to characterize a population of opioid-dependent university students who were treated with buprenorphine, describe their treatment outcome, and discuss challenges the authors faced in working with this population in the setting of a university counseling center. METHODS : We conducted a retrospective chart review of 27 opioid-dependent university students treated with buprenorphine at the university's counseling center. RESULTS : Students were predominantly white (85%, n = 23), male (63%, n = 17), average age of 22 years with an average of 33.4 ± 28.79 months (range = 4 to 132) opioid use before presentation. By self-report, 17 (63.0%) students reported heroin use, 9 (33.3%) students reported prescription opioid use, and 1 (3.7%) student reported use of both. Fifteen (56%) reported intravenous use. Treatment retention was high with students receiving an average of 12.00 + 11.49 months treatment (range = 1 to 36). During the course of treatment, 81% of all submitted urine drug screens were negative for opioids, 83.1% were negative for cocaine, 90.7% were negative for illicit (nonprescribed) benzodiazepines, and 59.1% were negative for marijuana. The average buprenorphine dose was 13.8 ± 5.69 mg (range = 4 to 24 mg). No serious adverse effects occurred. In working with this population, we found that continued marijuana use, engagement in treatment, financial concerns, and decision making around family involvement were ongoing challenges. CONCLUSIONS : Opioid-dependent university students are a unique group of substance users. Our results indicate that they can be safely and effectively treated with buprenorphine in a university counseling center.