There is a paucity in the literature examining the African American middle-class. Most studies of African Americans and Type 2 Diabetes Mellitus (T2DM) have concentrated on lower-SES individuals, or make no distinction between African Americans of varying socio-economic positions. Middle-class African Americans are vulnerable in ways often overlooked by researchers. This study quantitatively examines specific T2DM knowledge and perceptions of risk in middle-class African Americans (N = 121). The majority of respondents, 70.2%, were unable to correctly identify all the warning signs of T2DM development. Only 3.3% of respondents correctly identified all risk factors provided as 'possible causes' of T2DM development. The difference between those participants who considered themselves to be at risk for T2DM development and their level of risk, according to the American Diabetes Associations' risk assessment, was not statistically significant (P = 0.397). However, there were statistically significant differences between participants' perceptions of their weight and clinical definitions of overweight, a major risk factor in T2DM development, based on BMI (P = 0.000). Middle-class African Americans are not inherently protected or exempt from developing T2DM. This study demonstrates gaps in knowledge and overall incongruent levels of perceived susceptibility, suggesting a need for additional research and health education in this segment of the population.