Hypertension, diabetes, and obesity have contributed to the increasing number of strokes in young adults, and these risk factors are more prevalent among young adult African Americans (YAAA). These traditional cardiovascular risk factors often result from poor lifestyle choices (e.g., diet), and are therefore preventable, as with most strokes. The purpose of this secondary data analysis was to explore relationships between perceptions of stroke risk and competence to live a healthy lifestyle, health literacy, and dietary patterns to reduce stroke risk in YAAA. A cross-sectional, correlational analysis was conducted using baseline data from the Stroke Counseling for Risk Reduction (SCORRE) study. Participants (N=116) had a mean age of 25 years, were mostly female, college students, and averaged close to three modifiable risk factors for stroke. Overall, participants had poor dietary patterns based on the American Heart Association’s recommendations for cardiovascular risk reduction, perceived a low risk of future stroke, and had both high health literacy levels and high perceived competence to live a healthy lifestyle. When examining relationships between study variables, there was no association in health literacy levels and accuracy of perceived stroke risk. In addition, health literacy did not moderate the relationship between perceived competence to live a healthy lifestyle and dietary patterns. However, a higher perceived risk of future stroke and lower perceived competence to live a healthy lifestyle were significantly associated with poorer dietary patterns. As the incidence of stroke in young adults continues to increase, the need for primary prevention interventions that focus on YAAA and dietary behaviors is paramount, regardless of health literacy levels. Assessing the perceived risk of future stroke and perceived competence to live a healthy lifestyle could help to identify those YAAA who may need more education and resources to achieve dietary recommendations for stroke risk reduction.