COVID-19 spread worldwide from within months of its first identification and became the first pandemic of the twenty-first century. In response, countries instituted lockdowns, and conferences, gatherings, and exchanges at universities were restricted around the world. This chapter examines the impact of the COVID-19 pandemic on mental health and suicidality in university students. An overview of surveys of all generations provided data suggesting a worsening of various mental health conditions, such as depression and anxiety, in the early stages of the pandemic. However, later data did not show a situation as dire as was initially portrayed and indicated that the impact of the pandemic on suicide was negative. The results of investigations during the early stages of the pandemic around the world also showed worsening mental health, including depression, drinking, loneliness, and insomnia. Notably, data from the USA reported an increase in the main complaint of generalized anxiety in the long term. While some reports indicate that COVID-19 exacerbated university student suicide rates, suicidal ideation, and suicide attempts, others indicate that these decreased during the early stages of the pandemic, returning to prepandemic levels over time. These results indicate that the impact of COVID-19 on the mental health and suicide of university students remains largely unknown, as conflicting reports do and do not support it. However, there continue to be many cases of attempted suicide that professionals cannot prevent, which remains the same before and after the pandemic, and preventive measures are needed. In a pandemic, feelings of isolation and loneliness will likely to be exacerbated by infection control measures. To prevent suicides among university students who are experiencing crises in isolation, it is important to lower the barriers to requesting help and making people around them aware and connected. Furthermore, the data show an increase in suicide attempts and suicides among young women, not only in university students, and the importance of the need to improve support and measures for young women during pandemics is recognized.