The field of student health care lacks a positive identity in medicine and is often not well understood by the higher education community. This article explores the history, organization, staffing, utilization, financing, and governance of student health centers (SHCs). Student health centers are available to approximately 10 million of the 12.5 million US university students. As many as 27,000 individuals, including probably more than 3000 physicians, work in SHCs. Sources and amount of funds expended for this care vary widely from campus to campus, as does the intensity of services offered. A survey of this nation's largest institutions suggests that an average of $102 per student per year is spent on SHCs. The total amount spent on student health care in this country may exceed $1 billion each year. Student health care faces opportunities and obstacles in the future as our ability to promote health and prevent disease improves, as institutions of higher education allocate their limited educational resources, and as society determines where to invest its limited medical resources.