Despite college students’ high rates of depression, a large treatment gap remains in which many students in need are not receiving evidence-based care. This pilot randomized controlled trial (RCT) delivered a novel adaptation of Interpersonal Psychotherapy for College Students (IPT-CS) in group modality at a college counseling center. Of 97 students expressing interest, 18 with mild to moderate depression were randomized to IPT-CS or referral-to-usual-care. The nine who initiated IPT-CS treatment had an average 96.67% attendance rate across 10 sessions and rated IPT-CS as satisfactory and accessible. Facilitators also rated IPT-CS as satisfactory, feasible, and faithful to IPT. Group-by-time analyses indicated that IPT-CS, compared to referral-to-usual-care, yielded a pattern of medium to large effects for depression, anxiety, quality of life, social adjustment and support, interpersonal concerns overall, and disconnection/loneliness specifically. As the pilot trial was powered to detect quite large effects, group-by-time analyses only reached statistical significance for depression and social support, as did within-group analyses for quality of life and interpersonal concerns overall. Importantly, reductions in depression and anxiety were clinically significant, dropping from moderate at pre-intervention to mild/no signs at post-intervention. These findings have implications for improving the accessibility, reach, and impact of effective mental health services for college students.