Knowledge about differences in consumer perceptions of health risks and benefits related to fish consumption is important for the development of targeted health interventions associated with dietary choice. The purpose of this study is to identify individual differences in Russian consumers according to their perceptions of health risks and benefits associated with fish consumption. By application of a cluster analysis on perceptions of personal risks and benefits associated with the consumption of fish, four groups of Russian consumers were classified as: very positive; positive; moderately positive; and 'high risk-high benefit' about the healthiness of fish consumption. Differences in perceptions of personal risks and benefits across consumers were related to self-reported fish consumption, optimism about personal risks and benefits, and optimism about personal knowledge about risks and benefits. Implications for the development of targeted health interventions to influence perceptions of risks and benefits associated with fish consumption, and ultimately fish consumption, are discussed. It is concluded that optimism regarding perceptions and knowledge of health risks, and health benefits should be taken into account when developing interventions aimed at consumer health.