Local government fiscal health is typically assessed using objective financial indicators, but little is understood about how local officials subjectively understand their own fiscal health. We compare self-assessment data from the Michigan Public Policy Survey with financial data on Michigan local governments to explore the extent to which self-assessments align with conventional financial indicators. Qualitative results reveal that local officials emphasize long-term spending pressures (e.g. roads, infrastructure) and external factors, such as uncertainty around property values and state aid (i.e. revenue sharing) payments, when assessing their fiscal health. Quantitative results provide some corroborating evidence, but in general, conventional indicators are not powerful predictors of self-assessments, especially for high-stress governments. We believe that part of the disparity is that financial indicators do a poor job of capturing what local officials say they are most worried about. We suggest that self-assessments may be a useful supplement to conventional measures in capturing “true” fiscal health.