Background: Cardiometabolic risk factors are related to the early onset of chronic health conditions. Purpose: To identify factors associated with perceptions about the severity of three interrelated cardiometabolic risks (i.e., high blood pressure, obesity, and cardiovascular disease) among U.S. college students. Methods: Data were analyzed from 1,361 college students using an internet-delivered survey. Linear regression models were fitted. Primary independent variables of interest were sex and cigarette smoking status. Results: Relative to nonsmokers, smokers perceived high blood pressure (B = -0.09, P = 0.001), obesity (B = -0.12, P < 0.001), and cardiovascular disease (B = -0.12, P < 0.001) to be significantly less severe. Across models, females perceived all three cardiometabolic risk factors to be more severe (P < 0.005). Relative to non-Hispanic whites, Hispanic and Asian/Pacific Islander students perceived all three cardiometabolic risk factors to be less severe (P < 0.002). Compared to normal weight students, overweight (B = 0.41, P = 0.039) and obese (B = -0.72, P < 0.001) students reported higher severity perceptions about obesity only. Discussion: There are discordances between perceived severity of interrelated cardiometabolic risks among college students by personal factors. Translation to Health Education Practice: Smoking prevention and cessation interventions are needed to educate college students about cardiometabolic risks associated with cigarette smoking, especially among male and minority students.