Starting from the importance and purpose of school counselling, the article highlights the content-methodical specifics and assumptions of effective counselling work with students, and gives a brief overview of the practice of school counselling in Serbia. On that basis, this study aimed at examining school counsellors’ experiences in counselling elementary/primary school children (e.g., reasons for counselling, ways of implementation and difficulties). A sample of 81 school counsellors participated in a semistructured interview. The results show that undesirable behaviour and learning difficulties are the most common reasons for counselling, initiative is mainly coming from teachers or counsellors, and individual work and corrective counselling are more common. The difficulties respondents mentioned mainly related to the students’ personalities. The experiences of practitioners imply that the counselling practice insufficiently appreciates the importance of an integrative-systematic approach in student counselling. In this regard, the conclusion provides some recommendations that could contribute to improving the practice of counselling in schools in Serbia.