Equine interaction is emerging as an alternative therapeutic intervention and has proven to be beneficial for the mental health of college students. Accessibility to horses, however, can be a limiting factor for campuses without an equine program. On the other hand, virtual mental health services have grown in popularity due to accessibility and convenience, but current services do not offer virtual equine interaction opportunities. Therefore, the purpose of this study was to assess the effectiveness in reducing student stress levels using virtual equine interaction compared to in-person interaction with the horse. Survey responses and salivary cortisol samples were collected from two sample populations: A) college students directly interacting with a horse (n = 14) and B) college students interacting with a horse through virtual reality (n = 12). Both treatment types were performed at the same on-campus location and lasted under one hour. Collections of salivary cortisol and survey responses were taken pre- and post-equine interaction. Perceived stress levels were determined using a 4-point Likert Scale survey instrument with a lowering of scores reflecting reduction in stress. While cortisol concentrations did not change with direct equine interaction (P = 0.053) nor with virtual equine interaction (P = 0.091), both treatment types did significantly reduce perceived student stress levels (Virtual: P = 0.001, Direct: P = 0.0001). Further, cortisol concentrations (P = 0.071) and survey responses (P = 0.058) were not influenced by treatment type. The results suggest that direct interaction with the horse does not offer additional benefits over virtual equine interaction. As such, campus-based mental health interventions could utilize virtual equine interaction for addressing student mental health. This approach would make equine interaction more accessible to students that may have limited accessibility to working directly with the horse.