This study assessed whether immigrant adolescents receive health education and services in schools at levels comparable to native-born peers. Surveys from 2,635 8th and 10th graders allowed comparisons between students living in the United States "always" (n = 2,080), "more than six years" (n = 299), and "six years or less" (n = 191). Immigrant students were equally likely to receive health education, more likely to use peer counseling or support groups (p < .001), and less likely to use health services (p < .05). They communicated more often with staff (p < .05), were more concerned about mental health issues (p < .01), and were likely to have these topics addressed in school (p < .05). They were more positive about health education (p < .05), learned something new (p < .01), and communicated with parents when offered (p < .001). Schools provide a critical gateway and opportunity for reaching immigrant students and families with programs designed to meet their unique health and mental health needs. Questions remain, however, about health education and services being provided to non-mainstreamed, Limited English Proficient students who recently immigrated. Implications for program and service delivery and future research are discussed.