Suicide, as the third leading cause of death among individuals aged 15 to 24 years, is substantially more frequent in non-metropolitan/rural counties, where college/university students may be at particular risk; however, little is known about risk and protective factors and prevention strategies specific to this population. The current integrated review was completed to explore such factors and evidence-based interventions. A systematic literature search was performed, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and using computerized databases, for studies published from 2008 to 2021; nine met inclusion criteria. Data were classified into subgroups, which included risk and protective factors for suicidality, stressors and risk factors for psychological distress, and barriers to psychological help-seeking. Key findings included depression as a risk factor, religiosity as a protective factor, decreased social support as a stressor, and various barriers to help-seeking. No evidence-based interventions for this population have been identified in the literature. Research is needed to explore evidence-based interventions for rural college/university students. [Journal of Psychosocial Nursing and Mental Health Services, 60(9), 15-23.].