The purpose of this quantitative study was to explore whether fear and fatalism influence compliance with breast cancer screening among members of a selected target population of African American middle-class (AAMC) women. Using a cross-sectional analysis, a sample of 120 AAMC women, ages 35 and older, residing in Minnesota, was surveyed with an abridged version of the Champion Health Belief Model Scale (Champion, 1999), the Champion Breast Cancer Fear Scale (Champion et al, 2004), and an adapted version of the Powe Fatalism Model (Powe, 1995). Results indicated that fear and fatalism belief scores were statistically related to breast cancer compliance (p < .001). 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 this change should involve building cohesive physician-patient relationships. This action serves to counteract fear, fatalism, and negativism, and to increase the level of comfort among individuals who are more apprehensive about seeking health care services.