Aims: To describe the risk perceptions and factors associated with a high level of perceived risk for the development of Type 2 diabetes in a sample of Australian women with a recent history of gestational diabetes mellitus. Methods: Participants were women aged 18 years and over, diagnosed with gestational diabetes between 2003 and 2005, registered with the National Diabetes Services Scheme. Cross-sectional data were collected via written postal survey and included a self-reported risk perception scale. Results: Of 4098 invited, eligible women, 1372 consented to participate (response rate 36%). Respondents currently pregnant or subsequently diagnosed with Type 2 diabetes were excluded (n = 196). Up to 3 years post-gestational diabetes, 32% of women perceived that they were at a low or very low risk for developing Type 2 diabetes, 42% at moderate risk and 26% high or very high risk. Using logistic regression analysis, factors associated with high level of perceived risk were body mass index > 25 kg/m2 [odds ratio (OR) 4.50, 95% confidence interval (CI) (3.12, 6.51)], a family history of diabetes [OR 3.80, 95% CI (2.67, 5.33)] and use of insulin during pregnancy [OR 1.92, 95% CI (1.31, 2.61)]. Conclusions: Although women with known risk factors for Type 2 diabetes were more likely to perceive their risk as high, we found that one third still considered themselves to be at low or very low risk for the development of diabetes. These results suggest a need for increased awareness of gestational diabetes as a strong predictor of Type 2 diabetes risk.