Attending a university is one of the first major life transitions for many young adults, and it presents a number of important challenges, difficulties, and stressors. Thus, students with certain personality characteristics may be especially susceptible to developing adjustment problems while in college. Because vulnerable narcissism is associated with several characteristics that have been implicated as risk factors for poor adjustment to college (e.g., low self-esteem, use of maladaptive coping strategies, insecure attachment styles, and hypersensitivity to criticism), it may place college students at higher risk for maladjustment and negative health-related symptoms during their first year. This hypothesis was tested with a two-month longitudinal design in a sample of 319 first-year students during their first semester of college. Higher levels of vulnerable narcissism (but not grandiose narcissism) at Time 1 predicted poorer college adjustment, lower levels of social support, and higher levels of negative health symptoms at Time 2. Therefore, vulnerable narcissism appears to be a risk factor for developing health/adjustment problems during the first semester of college.