Objectives: To explore knowledge and attitudes about colorectal cancer (CRC) screening among African American patients age 45 and older at a community health center serving low-income and uninsured patients. Methods: We conducted 7 focus groups and 17 additional semistructured interviews. Sessions were audio-recorded, transcribed, and analyzed using standard text analysis. Results: Most participants who were age eligible for CRC screening were nonadherent according to national guidelines. Themes included low CRC knowledge, low perceived norms, high barriers, and other screening beliefs. Conclusion: Lack of knowledge, low perceived risk, and attitudes about CRC screening may be important targets for interventions in low-income African American patients.