The purpose of the study was to examine factors such as the number of years lived in the U.S., English proficiency, neuroticism, openness, and music therapy student academic stress (MTSAS) that predict acculturative stress among international music therapy students studying in the U.S. An on-line survey was conducted with a U.S. sample of international music therapy students. Among the 134 participants who originally came from 25 countries returned the survey, 97 with complete data (88 women and 9 men; 38 undergraduate and 59 graduate students) were included in the main analyses. Results showed this sample had a substantially higher mean on acculturative stress (M = 83.04) than the normative mean (M = 66.32) reported by Sandhu and Asrabadi (1994). In addition, 13 participants’ (12.89%) scores were within the “high risk” category, indicating the need for psychological intervention. Asian students were found to have experienced a higher level of acculturative stress than their European counterparts. There were no significant differences found between undergraduate and graduate students relating to levels of acculturative stress. Correlational analyses indicated that acculturative stress had significant correlations with level of English proficiency, neuroticism, and MTSAS. There were no significant findings regarding years lived in the U.S., openness, and level of acculturative stress. Regression analyses revealed that (a) the entire set of 5 aforementioned predictors accounted for 41% of variance in acculturative stress, which is considered a large effect size, and (b) among these predictors, English proficiency, neuroticism, and MTSAS appeared to be the most powerful predictors of acculturative stress. In addition, making presentations, taking exams, and participating in class discussion were found to be the most stressful classroom activities. Implications for music therapy and future research directions are discussed.