Rescuers were able to find them - hungry and cold - after an hours-long effort in rough terrain and freezing temperatures.
Most of the hikers were seen in the emergency room at Appalachian Regional Hospital in Whitesburg, with one woman admitted and listed in good condition, spokeswoman Dena Sparkman said Friday.
The few who declined to be seen at the hospital "were like, 'feed me and we're good,'" Sparkman said.
"I think the best medicine we gave them was chicken soup," Sparkman said.
The group was made up of 37 students and three staff members from La Salle University on an annual mission trip called Project Appalachia, said John Caroulis, spokesman for the Philadelphia school.
Caroulis said the group was helping build houses in Harlan, about a half-hour from Whitesburg, and had gone on a hiking trip that was made every year on the trip.
Rescuers said the group got disoriented when it got dark while they were hiking near Bad Branch Falls, an area on the Bad Branch Nature Preserve.
A search began about 7 p.m. EST Thursday, and it took until 3:30 a.m. Friday to get the entire group off the mountain, said Mayking Volunteer Fire Chief Tony Fugate, who helped.
"It's pretty rough country back in there," Fugate said.
Fugate said the group apparently hiked to a popular spot above the Bad Branch Falls waterfall, but it got dark and they couldn't find the trail back. When they got disoriented, they called 911 from their cellphones and were able to talk rescuers toward them.
They were on a 5-mile trail shaped like a lollipop headed to an area called High Rock, which is known for its breathtaking views, according to Shad Baker, a local resident who created many of the public trails used in the area and helped guide rescuers via cell phone.
"Rescuing 37 people is a monumental undertaking," Baker said. "So the fact that they got them out is really good."
The trail, lined with hemlock trees and rhododendron bushes, takes hikers immediately into the deep woods. A sign at the trail head warns hikers to stay on the trail. A visitor log at the entrance to the trail was signed "La Salle University" for March 8.
Baker said the hikers didn't arrive at High Rock until 5 p.m., it began to get dark, and much of the trail was covered by trees, branches and snow. He said the group would have had to cross three streams to reach the destination, and rescuers said by the time they arrived, many of the hikers said their feet were numb.
"I think once they got up there, there's 37 footprints going every which direction. ... I think they couldn't figure out which way they came from," Baker said.
Baker said to make things more confusing, the trail that would have taken them down the mountain actually goes uphill before it goes downhill.
"It's counterintuitive," he said.
He said the group was not dressed for the weather, with most of them wearing just sneakers, jeans and light jackets as temperatures began dropping into the 20s.
Fugate said only a few of the students had flashlights.
The group had to be walked down the mountain using an alternate route that had fewer obstacles but took more time, Baker said.
National Weather Service meteorologist Ed Ray said temperatures in the Pine Mountain area dipped into the low 20s overnight. He said the high Thursday reached only into the mid-20s.
Caroulis said the group was expected to return to Pennsylvania on Saturday as scheduled.