<p>People continue to migrate globally in search of safety and stability, bringing both strengths and complex trauma histories that shape early resettlement. At the same time, resettlement policies and supports vary widely, influencing how newcomers access resources and navigate adjustment. Guided by ecological and health service utilization perspectives, this study frames service utilization as a dynamic process of adaptation within shifting policy and service contexts. Within this framework, the authors examine classes of service utilization in resettlement- and employment-related case management, clinical sessions, and psychiatric services as well as predictors of class membership among a sample of refugees (<i>n</i> = 633, 53.9% female) living in the USA to understand early resettlement service utilization. Compared to low utilizers, refugees with PTSD symptoms, fewer adjustment difficulties, and older age at intake were more likely to utilize psychiatric services, while those reporting family conflict were more likely to use clinical support alongside resettlement services. These findings underscore the central role of trauma in shaping service use and suggest that family conflict may be more common among those needing brief, nonpsychiatric support. Additionally, findings point to the need for integrated resettlement and mental health services that address trauma, adjustment challenges, and structural barriers to service utilization.</p>