Trends in college student health based on an annual survey of college freshmen administered for 30 consecutive years (1966–1995) at colleges and universities nationwide are described. Trends in the following areas are covered: (1) alcohol and drugs, (2) physical health, (3) psychological health, and (4) sexual attitudes. Gender and institutional differences in health behaviors and attitudes among the 1995 class of college freshmen are also considered. Major trends include declines in beer drinking and in physical and emotional self-confidence and an increase in stress and cigarette smoking. „Unhealthy” behaviors and attitudes are reported most often by freshmen at public 2-year institutions.