The Indo-Pacific Red Lionfish was first reported off the Florida coast in 1985, following which it has spread across much of the SE USA, Gulf of Mexico, and Caribbean Sea. Lionfish negatively impact fish and invertebrate assemblages and abundances, thus further spread is cause for concern. To date, the fish has not been reported on the Pacific coast of North or Central America. Here we examine the possibility of ballast water transfer of lionfish from colonized areas in the Atlantic Ocean to USA ports on the Pacific coast. Over an eight-year period, we documented 27 commercial vessel-trips in which ballast water was loaded in colonized sites and later discharged untreated into Pacific coast ports in the USA. California had the highest number of discharges including San Francisco Bay and Los Angeles-Long Beach. A species distribution model suggests that the probability of lionfish establishment is low for the western USA, Colombia and Panama, low to medium for Costa Rica, Nicaragua, El Salvador and Guatemala, medium to high for mainland Ecuador, and very high for western Mexico, Peru and the Galapagos Islands. Given the species’ intolerance of freshwater conditions, we propose that ballast water exchange be conducted in Gatún Lake, Panama for western-bound vessels carrying ‘risky’ ballast water to prevent invasion of the eastern Pacific Ocean