The relationship between resilience and mental health was examined in three phases over 4 years in a sample of 314 college students in China. The present study aimed to gain insight into the reciprocal relationship of higher levels of resilience predicting lower levels of mental ill-being, and higher levels of positive mental health, and vice versa, and track changes in both resilience, mental ill-being and positive mental health over 4 years. We used the Depression Anxiety Stress, the Positive Mental Health, and the Resilience Scales. Results revealed that first-year students and senior year students experienced higher negative mental health levels and lower positive mental health levels than junior year students. Cross-lagged structural equation modeling analyses showed that resilience could significantly predict mental health status in the short term, namely within 1 year from junior to senior year. However, the predicting function of resilience for mental health is not significant in the long term, namely within 2 years from freshman to junior year. Additionally, the significant predicting function of individuals' mental health for resilience is fully verified for both the short and long term. These results indicate that college mental health education and interventions could be tailored based on students' year in college.