Counseling services are integral to holistic healthcare delivery, particularly in addressing the psychosocial needs of patients and healthcare professionals. Despite their recognized importance, evidence suggests inconsistent engagement with these services, even among counseling professionals. This study assessed the knowledge, perception, and utilization of counseling services among counselors at Irrua Specialist Teaching Hospital (ISTH), Edo State. A descriptive cross-sectional survey design was employed, using total sampling to include all eligible counselors. Data were collected through a structured, self-administered questionnaire and analyzed using SPSS version 26, with descriptive and inferential statistics applied at a 5% significance level. Results indicated universal awareness (100%) of counseling services among respondents; however, only half had received formal training, and 70% were knowledgeable about referral protocols. Perceptions of counseling services were generally positive, although concerns regarding staffing adequacy and service structure were noted. Utilization was high for patient referrals (90%) but comparatively low for personal use (40%). Major barriers identified included workload constraints, stigma, lack of institutional support, cultural and religious beliefs, and inadequate personnel. The study concludes that while counselors at ISTH demonstrate high awareness and favorable perceptions of counseling services, significant gaps remain in training, personal utilization, and organizational support. Strengthening institutional policies, expanding training opportunities, and addressing systemic and sociocultural barriers are essential to improving counseling service utilization and promoting mental well-being within tertiary healthcare settings.