In flood risk management, a shift can be observed toward more integrated approaches that increasingly address the role of private households in implementing flood damage mitigation measures. This has resulted in a growing number of studies into the supposed positive relationship between individual flood risk perceptions and mitigation behavior. Our literature review shows, however, that, actually, this relationship is hardly observed in empirical studies. Two arguments are provided as an explanation. First, on the basis of protection motivation theory, a theoretical framework is discussed suggesting that individuals’ high-risk perceptions need to be accompanied by coping appraisal to result in a protective response. Second, it is pointed out that possible feedback from already-adopted mitigation measures on risk perceptions has hardly been considered by current studies. In addition, we also provide a review of factors that drive precautionary behavior other than risk perceptions. It is found that factors such as coping appraisal are consistently related to mitigation behavior. We conclude, therefore, that the current focus on risk perceptions as a means to explain and promote private flood mitigation behavior is not supported on either theoretical or empirical grounds.