Health disparities are prevalent in the U.S, with low-income African American children suffering from higher rates of obesity and chronic diseases compared to White children. Currently, little is known about parental perceptions of healthy eating, and concerns related to child health and weight in this at-risk population. The main purpose of this study was to examine perceptions, motivating factors and barriers to healthier eating in a sample of low-income African American parents of 3-5 year old children. The second purpose was to assess parental concerns about health and/or weight and to examine the accuracy of parental perceptions of child weight status. Participants were recruited from Head Start Programs in North Carolina. The Social Cognitive Theory constructs guided focus groups and a survey administered to the participants. Content analysis of 8 focus groups generated the following themes: 1) lack of nutrition knowledge and misconceptions; 2) healthy meals are home-cooked, include meat and starch; 3) family members, lack of maternal modeling, and child pickiness are main barriers to healthier eating; 4) strong awareness of family history of chronic disease, including obesity; 5) lack of concern about child's current weight. Over 25% of mothers underestimated their child's weight status. Our findings highlight important maternal perspectives influencing children's diet quality and long-term health outcomes among low-income at-risk preschoolers. Nutrition educators should be aware that low-income African American mothers may be aware of chronic disease risks, but do not perceive food choices in early childhood as having strong impact on the child's future health