The purpose of this quantitative study was to explore whether fear and fatalism influence compliance with breast cancer screening among a selected target population of African American middle class (AAMC) women. Cross-sectional analysis of a subsegment sample of 120 AAMC women ages 35 and older who reside in Minnesota were surveyed using an abridged version of the Champion Health Belief Model Scale (CHBMS), which is based on the health belief model, the Champion Breast Cancer Fear Scale (CBCFS), and an adapted version of the Powe fatalism model (PFM). These data were analyzed by applying descriptive statistics and conducting logistic regression to calculate CHBMS constructs and compare AAMC women who comply with American Cancer Society guidelines to those who are noncompliant in relation to the 2 variables fear and fatalism. Results indicated that fear (χ² (2) = 23.49, p < .001) and fatalism (χ² (1) = 21.04, p < .001) belief scores were statistically related to breast cancer compliance. These barriers suggest a greater need for health interventions that are culturally specific with the intention of improving the psychological aspects of health to address fear and fatalism. The social dimension of change should involve building cohesive physician-patient relationships. This action serves to counteract fear, fatalism, and negativism and increase the levels of comfort among those individuals who are more apprehensive about seeking health care services. Future research might identify strategies to address fear and develop tactful approaches to dismantle some of the philosophical doctrines associated with fatalism.