Counseling and psychotherapy with young males has always posed special challenges to the clinician. Given recent important changes in social conceptions of manhood and masculinity and questions about best practices in mental health care, the existential approach to working with males in their late teens and early adult years provides an alternative modality that responds to both areas of change. The guiding principle of Existential Therapy (ET) is that no matter what the presenting symptoms, the underlying reason for seeking therapy is to confront the ultimate concerns of existence. This is relevant to work with young males for whom such concerns are coming into prominence, often for the first time, with great impact.