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Introduction: The American Heart Association (AHA) Go Red for Women campaign has substantially improved awareness of heart disease among adult women over the past fifteen years, as demonstrated by triennial surveys of women ages 25 years and older. Little is known about awareness among younger women, who represent a key time in the life course for primordial prevention. We hypothesized that adolescent and young adult women 15 to 24 years of age would have lower rates of heart disease awareness than women 25 years of age and older.Methods: We assessed awareness of heart disease and prevention efforts among young women ages 15-24 years using the AHA National Women’s Health Study survey. Participants were a random convenience sample of 103 women recruited from the waiting rooms of two clinical practices (one community health center and one academic medical center). We performed statistical comparisons of this cohort to responses from the 2012 AHA National Women’s Health Study survey of 168 women ages 25-34 years using the chi-square test (binary responses).Results: Only 13 (13%) adolescent and young adult women correctly identified heart disease as the leading cause of death in women. This was significantly lower than the rate of awareness of adult women overall in 2012 (56% of 2432) and of women ages 25-34 years (44% of 168) (p<0.001 for both comparisons). Almost half of the young women surveyed in the current study [(n= 44 (43%)] said they were not at all informed about heart disease. While physicians emerged as the preferred source of information about heart disease among participants, the majority [n=64 (62%)] had never spoken to a health care professional about their risk of heart disease. Most young women surveyed worried little [n = 44 (43%)] or not at all [n = 40 (39%)] about heart disease; mood disorders were the most common concern in this age group, followed by sexual health issues. Despite a lack of general awareness about heart disease, many young women did report engaging in activities known to reduce the risk of heart disease, including getting regular exercise [n = 81 (79%)], maintaining healthy blood pressure [n = 76 (74%)], reducing sugar intake [n = 48 (47%)], and losing weight [n = 48 (47%)]. A significantly higher proportion of women ages 15-24 years aimed to maintain a healthy blood pressure and get regular exercise compared to those ages 24-34 (p<0.02), whereas a similar proportion aimed to lose weight and reduce sugar intake (p>0.7).Conclusions: Adolescent and young adult women are largely unaware of heart disease as the leading cause of death in women. As the antecedents of heart disease begin in childhood and adolescence, these findings demonstrate a major unmet need. Given most young women are not worried about heart disease at this life stage, campaigns to promote heart healthy behaviors should underscore the benefits of these prevention behaviors to mood and emotional health.