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University students are a high-risk population for acquiring sexually transmitted infections (STIs). However, the rates of sexual health service utilization among this population remain low. In this study, we sought to describe the rates and predictors of sexual health service use among undergraduate students at two Nova Scotia universities. An online survey of eight Canadian Maritime universities was conducted to collect information on undergraduate students' sexual health behaviours (n = 10,631). We conducted a secondary analysis on a subset of the data collected from sexually active undergraduate students at two Nova Scotia universities (n = 3,709). The majority of sexually active female students (73%) and 20% of male students accessed sexual health services at least once in their lifetime. Fewer sexually active students (41% females; 25% males) have ever had an STI test. Twenty-two percent of female students and 8% of male students had ever accessed sexual health services at their university health centre. Non-heterosexual students were less likely to access sexual health services on campus than heterosexual students. Among female respondents, those who reported a greater sense of social support were more likely to access sexual health services on campus. Our results illustrate the characteristics of university undergraduate students who do and do not access sexual health services on campus. These findings will be used to inform the design of a qualitative study to further explore the perceived barriers and enablers to sexual health service use at university health centres.