Of the small number of deaf and hard-of-hearing students who enroll in mainstream colleges and universities, between 60% and 80% do not persist to attain a college degree. Reasons for the high attrition rate are several, including academic and social difficulties and dissatisfactory experience with college life. This study uses case study methods to illustrate the complex phenomenon of how deaf and hard-of-hearing students are integrated academically and socially into college life at a Carnegie Research-I university. Data gathered from surveys, open-ended interviews, and focus groups are analyzed and used to describe the perspectives of 10 study participants, five undergraduates and five graduates. Documentary evidence and theoretical sampling are other methods used. Data were collected during three semesters. The findings showed that when deaf and hard-of-hearing students are positively integrated into college life, they are more likely to maintain a high level of commitment to college and persist. Pre- and within-college factors that assist the students in their dynamic decision-making process of enrolling and staying in a mainstream university include the following factors: previous mainstream experience, development of study skills and support systems, ability to self-advocate, and level of commitment to attaining a college degree. Additional influence on persistence was the availability of support from the office of disabled student services (DSS) through services such as sign language interpreters and note-takers. The findings are compared to existing literature and theory and are used to raise additional questions for further study. Recommendations for colleges and universities as well as policy-makers working with this student population are provided.