This PhotoVoice study explored the experiences Queer, Trans, Black, and Indigenous People of Color (QTBIPOC) had in substance use disorder counseling. Specifically, this study examined experiences of both minority stress and affirmative counseling in substance use disorder counseling with QTBIPOC. A significant focus on critical participatory action research was utilized in this study so that participants collectively reflected on their experiences in substance use disorder counseling and collaboratively brainstormed action plans that need to take place to address QTBIPOC community concerns in counseling. Substance use disorder counselors and counselor educators can benefit from the implications of this study to determine culturally affirmative approaches in working with QTBIPOC and addressing their concerns with substance use and minority stress. Therefore, this study informs substance use disorder counselors about strategies to enhance their counseling care with QTBIPOC.