Little is known about the perception of lifetime risk for cardiovascular disease (CVD). Researchers recruited subjects from the Dallas Heart Study, and each subject was classified as high or low for risk of CVD. Subjects were then assessed for their perceived lifetime risk for a myocardial infarction. There was significant discordance between perceived and predicted lifetime risk. Family history of premature myocardial infarction, high self-reported stress, and low perceived health were all associated with high perceived lifetime risk, whereas the association between traditional CVD risk factors and high perceived lifetime risk was more modest. These findings highlight the importance of effectively communicating the significance of traditional risk factors in determining the lifetime risk for CVD.