Purpose: In this study, we compared United States (US) and Taiwanese college students’ using alcohol, coping strategies, anxiety, and depression. Research Questions: 1. What were the differences in demographic characteristics, using alcohol, coping strategies, anxiety, and depression between US and Taiwanese college students? 2. What were the relationships between US and Taiwanese college students’ using alcohol, coping strategies, anxiety, and depression? 3. How much of US and Taiwanese college students’ anxiety and depression were predicted by their use of alcohol, coping strategies? Methods: Four hundred and one US and 180 Taiwanese college students were recruited in this study. This was a cross-sectional comparative research design. SPSS 28.0 was used to do the data analysis. The Descriptive data analysis, Chi-square tests, independent t-tests, Pearson Correlations, and Stepwise Multiple Regressions were used to examine the research questions. Results: More US college students were married, believed in Jesus Christ, had higher incomes, and were older than Taiwanese college students. Compared with Taiwanese college students, US college students had higher scores in using Problem-Focused Disengagement, but lower scores in Emotional-Focused coping strategies, depression, and using alcohol with negative emotions. The significant predictors for the US and Taiwanese college students’ anxiety and depression were using alcohol with negative emotion, using Problem-Focused Disengagement, using Emotion-Focused Engagement, and using Emotional-Focused Disengagement. Taiwanese college students had another significant predictor for depression which was Problem-Focused Engagement. Conclusions/Implications for Practice: The significant factors associated with anxiety and depression were found in this study.