Hong Kong universities offer counselling services for students, but students often do not actively seek such services when they need them. This study used quantitative and qualitative methods to investigate the relationship between attribution styles, attitude and other factors that may affect university students’ use of counselling services. The study involved 292 student participants from Hong Kong. Overall, 279 students participated in the quantitative study, and 13 in the qualitative study. For the quantitative study, 56 participants (22 males; 34 females) were from University A and 223 (67 males; 156 females) were from University B. For the qualitative study, one participant (one female) was from University A and 12 participants (three males; nine females) was from University B. The Attributional Style Questionnaire (ASQ) and the Inventory of Attitudes Toward Seeking Mental Health Services (IASMHS) were used in the quantitative part of the current study. The ASQ was used to measure the attribution style of participants in three causal dimensions, including ‘Internality’, ‘Stability’ and ‘Globality’, and the IASMHS was used to measure the participants’ attitudes towards counselling help in three ways: ‘psychological openness’, ‘help-seeking propensity’ and ‘indifference to stigma’. Results from the quantitative study showed that girls had higher ‘indifference stigma’ in their attitudes towards counselling help than boys. Participants who had previously sought counselling help showed higher ‘psychological openness’ in their attitudes towards counselling help than those who did not. Moreover, the students’ study majors and religious beliefs were significant predictors for ‘psychological openness’ in multiple regressions. Participants’ responses in the qualitative study were systematically analysed under three main themes, including ‘Problems faced by university students’, ‘Self and others’ past experiences in seeking counselling help’ and ‘Students’ attitudes and perception