We examined risk perceptions that aquatic-based recreation stakeholders in the Great Lakes region held about fish diseases, using viral hemorrhagic septicemia (VHS) as our case study. Eighty-five percent of study participants knew nothing or very little about VHS. Regarding risks posed by VHS, participants overall were most concerned about risks to the environment and fishing. Additionally, greater than 75% were concerned about fish diseases, in general, affecting the Great Lakes or inland lakes. Outreach efforts can be enhanced by focusing on areas of greatest risk invasion; targeting boaters, paddlers, kayakers, and anglers; increasing awareness of and concern about fish diseases; and communicating actions boaters should take.