Unaccompanied children (UC) are a vulnerable group of immigrants who arrive to the United States (US) without parents or caregivers, and experience various losses and traumatic stress before, during, and after their migration to the US. This cross-sectional study examines factors associated with reporting mental health services as a primary need in a sample of UC in 2019 (n = 851). Results show that older UC and UC from Honduras have higher odds of reporting mental health services as a primary need, and male UC, compared to female UC, have lower odds of reporting mental health services as a primary need.