This chapter examines the great range of multiple influences on risk perception in many parts of the world. It argues that only by understanding in intimate detail the daily reality of individuals’ lives, including the socio-political context, and exactly how they and communities perceive risk can we hope to develop risk communications that reach and influence them. The practical implications for communication for differing perceptions of risk are reviewed. In the last section, some general risk communications principles and specific methods are described. In this chapter, the term pharmacovigilance is taken to mean not just the monitoring and reporting of adverse drug reactions (ADRs), but also the much broader range of concerns in the field of patient safety. It is also assumed that best practice pharmacovigilance includes the essential element of communicating useful data and information about safety to the world to support wise therapeutic and public health decisions. The purpose of risk communication in clinical practice and public health is to inform and protect and to support wise, balanced and rational decisions that match patients’ and citizens’ wishes and needs and keeps them safe. There are references in the chapter to the acute risk perception and risk management issues arising during the COVID-19 pandemic.