Background: Rapid advances in digital technology have transformed mental health services, including the implementation of online counseling for Generation Z in an educational context. Aim: This study aims to comprehensively examine online counseling services for Generation Z, focusing on service models and approaches, effectiveness, and challenges in their implementation. Method: This study employed a Systematic Literature Review (SLR) approach. The literature search was conducted using the Publish or Perish application to access the Google Scholar and Scopus databases with relevant keywords. A total of 28 articles meeting the inclusion criteria were analyzed using a thematic synthesis approach. Results and Discussion: The findings indicate that online counseling services are evolving in various forms, such as chat-based, video-based, and multi-platform services, including innovations based on applications and the metaverse. The approaches employed are flexible and adaptable to clients’ needs. In terms of effectiveness, online counseling has been shown to reduce anxiety, stress, and depression, as well as improve psychological well-being and help-seeking behavior. The effectiveness of this service also tends to be comparable to face-to-face counseling under certain conditions. However, there are various challenges, such as limitations in non-verbal communication, low client engagement, as well as issues of trust, privacy, and stigma. Conclusion: Online counseling services have significant potential to support the mental health of Generation Z, but require adaptive strategies such as the development of blended counseling, enhancing counselors’ competencies in a digital context, and strengthening the ethical and safety aspects of the service to improve service quality.