The Extended Parallel Process Model (EPPM; Communication Monographs, 59, 1992, 329) is a predominant message design theory in the social science fear appeal literature that provides a framework for effective communication of health-related information. This paper provides a review and update of the theory and the use of fear appeals in persuasion. First, a brief overview of the EPPM is provided. Then, Littlejohn and Foss (Theories of Human Communication, 2005, Belmont, CA: Thomson Wadsworth) criteria for evaluation of theory are used as a guide for reviewing research guided by the EPPM in terms of the consistency of data with theoretical predictions, how it has been adjusted and extended through research findings, and a discussion of future research to expand social scientific knowledge about fear appeals and persuasion. It is concluded that the EPPM has advanced our understanding of how fear appeals operate and continues to generate questions for research in risk messaging.