This study aimed to explore the development, implications, challenges, and prospects of counseling work at Taiwan’s colleges and universities for more than 60 years. This study employed the literature analysis and document analysis methods to explore the current situation and challenges from three aspects of counseling, namely organizational position and manpower allocation, three levels of guidance and counseling and transition mechanism, and performance evaluation and self-improvement mechanism. It anticipated the following prospects: redefine and clarify the professional image and organizational position and role and function of guidance and counseling units in colleges and universities. Additionally, according to the comprehensive professional definition and by integrating the division of work, a campus ecological system based on a cooperation model should be established, fostering a positive counseling image and collectively promoting the three levels of guidance and counseling. It is recommended that government or academic organizations establish a database or big data platform to acquire current information and trends to expand and improve guidance and counseling work. Regarding performance, it is advisable to incorporate institutional research to establish an evidence-oriented and continuous improvement mechanism for school-based counseling characteristics and quality assurance systems and develop an authentic and rigorous guidance and counseling credential-awarded mechanism. Guidance and counseling professional associations should promote effectiveness evaluation, performance presentation, and counseling work quality assurance system of each school, broadening the implications and scope of colleges and universities’ counseling. Simultaneously, to cope with the ever-increasing needs and challenges of counseling, it is advisable to enhance the functions of the regional platform to ensure the quality and effectiveness of counseling work. Guidance and counseling in the post-epidemic era should be integrated with emerging technologies to develop technological consultation work that can align with current trends.