Little is known about the relationship between real and perceived water competence among youth in the context of drowning prevention or of their perceptions of their risk of drowning. This study reports the findings of an international project entitled Can You Swim? The participants (n = 373) were assessed in a two-part study using an initial questionnaire survey to provide self-estimates of water competency and risk perception, followed by six practical tests in the water. Correlation coefficients between perceived and real swimming competency (rs = 0.369) and floating (rs = 0.583) were significant, but only moderate in strength. No significant gender differences in real or perceived swimming competency were found. Significantly more males than females estimated lower risk of drowning associated with a series of aquatic scenarios (p = 0.016). The implications of these findings on drowning prevention and the need for further investigation are discussed.