Lesbian, gay, bisexual, trans, queer (LGBTQ+) students face elevated risks of stigma, prejudice, and discrimination within college and university environments. This systematic review examines the prevalence of these kinds of harm experienced by LGBTQ+ students. Five databases were searched, from which we found 60 studies that met our inclusion criteria. Only quantitative results were included, with results grouped into 12 forms of harm (e.g., discrimination, harassment, physical harm and threat). Adverse experiences were commonly reported among LGBTQ+ students, and multiple correlates of harm were identified. Most studies focused on experiences among LGBTQ+ students overall, with few investigating experiences of harm specific to gender minority students. Intersectionality was also rarely considered. Findings suggest that on-campus prejudice, stigma, and discrimination are issues faced by LGBTQ+ students. These harms are heightened by various individual and structural factors. However, findings should be interpreted with caution as all included studies used a cross-sectional design. Future research should prioritize longitudinal designs, intersectional approaches, and considerations about the role of structural stigma.