Objective: To investigate the psychological distress, and examine the effects of acculturative stress, positive coping, and negative coping and their interaction on psychological distress among international students in China. Methods: Totally 373 international students were surveyed from central China [being in China of (2. 2 ± 1. 7) years, 248 males, and 125 females]. Psychological distress was measured with the short version of Brief Symptom Inventory (BSI-18), acculturative stress was measured with the Acculturative Stress Scale for International Students (ASSIS), and positive coping (PC) and negative coping (NC) were measured with the Cope Inventory (COPE). Results: The average score of BSI-18 was (0. 66 ± 0. 72). The BSI-18 scores were positively correlated with the scores of ASSIS and NC (r = 0. 49, 0. 31, Ps ＜ 0. 001). Multiple regression showed that the scores of ASSIS, NC, and interaction of ASSIS and NC were positively correlated with the BSI-18 scores (β = 0. 43, 0. 19, 0. 26). Conclusion: Acculturative stress and negative coping are important related factors for psychological distress, and for students suffering higher acculturative stress, the effect of negative coping on psychological distress is larger.