Drinking alcohol during pregnancy is a risk factor in a range of adverse birth outcomes, including fetal alcohol spectrum disorders, and is a major health concern. For this behaviour to change one of the necessary conditions is for women to have an accurate perception of the risks drinking during pregnancy poses. A major obstacle to this is the presence of unrealistic optimism which leads to women believing they are less at risk than others. This study examined a sample of women ( N = 129) from a community in the Northern Cape Province in South Africa with a high prevalence of fetal alcohol spectrum disorder for signs of unrealistic optimism. A questionnaire about the perception of personal and general risk was administered during a one-on-one interview and responses compared. Neither a Student’s t-test ( t(115) = −1.720, p = .088, 95% confidence interval [−0.180, 0.013]) nor a Wilcoxon matched-pairs signed-rank test ( z = −1.72, p = .285) showed a significant difference. The perception of risk posed by drinking during pregnancy to others, knowledge of fetal alcohol spectrum disorder, and the perception of how easy it would be for the participant to quit drinking were significant predictors of the perception of personal risk. Only the perception of personal risk predicted the perception of general risk. There was no evidence that participants believed themselves to be less at risk than their peers when it came to the risks of drinking during pregnancy. Future directions for research into unrealistic optimism and drinking during pregnancy are discussed.