Asian immigrant-origin youth (IOY) are a large and growing population within the United States (U.S.). Yet, despite the high prevalence of mental health concerns, limited research has examined sources of stress that may lead to mental health concerns among Asian IOY. Further, despite low levels of mental health service use, no studies have directly explored the perceptions of Asian IOY about barriers to mental health service use generally. Hence, using a qualitative approach, this study sought to examine the perceptions of Asian IOY regarding sources of stress that may contribute to mental health concerns and barriers to mental health service use. Thirty-three (n = 33; 58% female) Asian IOY were directly queried through in-depth focus groups. Data were analyzed using a grounded theory approach. Themes relating to sources of stress that lead to mental health concerns among Asian IOY included (a) pressure to succeed and (b) stressors related to ethnic minority and immigrant status. Themes relating to barriers to mental health service use among Asian IOY included (a) parental reactions, (b) concerns with mental health treatment, (c) stigma against mental health services, (d) mental health literacy, and (e) pragmatic or logistical reasons. Findings provide insight into tailoring appropriate outreach efforts to increase mental health service use among Asian IOY.