Background: Intake of tree nuts and peanuts is associated with reduced risk of cardiovascular disease (CVD) and diabetes. However, no studies have been published on beliefs, attitude, perceived barriers and benefits, and knowledge regarding tree nuts and peanuts among individuals with or at risk for these conditions. Methods: The objective of this study was to assess the beliefs, attitude, perceived barriers and benefits, and knowledge regarding tree nuts and peanuts intake among 85 Caucasian and African Americans (mean age 63 years) individuals with or at risk for CVD and/or diabetes. A survey questionnaire was utilized to collect date from to healthcare facilities in a small town in southeastern United States. Results: About 32% were unaware of the hypocholesterolemic effects of nuts and an additional 21% disagreed that nuts exhibit such effects. Fifty-three percent agreed or strongly agreed that eating tree nuts and peanuts would help them to be healthier. Most participants (63%) strongly agreed or agreed with the statement, “I would eat nuts on most days of a week if my doctor recommended me to do so.” About one-third of the participants strongly agreed, agreed, or neither agreed/disagreed with the statement, “I should not eat nuts on most days of the week because I would gain weight.” The majority of participants answered all five knowledge questions concerning the nutrient content of tree nuts and peanuts incorrectly Conclusions: The results indicate that the beliefs and knowledge of individuals with or at risk for CVD and/or diabetes are largely inconsistent with the scientific findings. The results also indicate that the best way to change attitude, perceived barriers and benefits could be accomplished by physicians.