Although direct-to-consumer (DTC) prescription drug advertising is regulated by the U.S. Food and Drug Administration, content analyses (Baird-Harris, 2009; Frosch, Krueger, Hornik, Cronbolm, & Berg, 2007; Kaphingst, DeJong, Rudd, & Daltroy, 2004; Wilkes, Bell, & Kravitz, 2000) and other studies (Davis, 2000, 2007) have suggested that advertisers may not disclose drug risks to the same extent that they describe drug benefits. This study builds on previous studies by Baird-Harris and Smith and Shaffer (2000) and aims to test the relationship between image congruency in televised DTC advertisements, recall of risks and benefits, and perceived ad persuasiveness. Advertisements for Nexium, Advair, and Lunesta were shown to college students in either their original (i.e., image incongruent) or modified (i.e., image neutral) form. In general, risks were easier to recall with image neutral advertisements (which were considered to be less persuasive), although results were not statistically significant. Gender had a significant interaction effect, suggesting that males and females process risks differently depending on images in a DTC advertisement. Despite its lack of significant findings, this study explores an underdeveloped area of research and provides a model for future studies.