SIGNIFICANCE. Popularity of e-cigarettes is growing at an alarming rate among LGBTQ individuals since they smoke more and experience poorer health outcomes. Misconceptions and lower harm perceptions may encourage to use e-cigarettes and become a gateway to smoking or discourage smokers to quit. This study describes e-cigarette harm perceptions and association with current and future use among LGBTQ tobacco users. METHODS. We measured e-cigarette prevalence, harm perceptions, intention to use, and socio-demographic factors associated with smoking from health needs assessment data of adult LGBTQ individuals (N=436) in the Southeastern US. RESULTS. Results show that 13% of LGBTQ use e-cigarettes compared to the 11% nationally and 52% are poly-users. E-cigarette use was greatest among trans men (14%), cisgender males (13%), and queer (33%). Primary uses of e-cigarettes are to quit smoking (42%), deal with stress (29%), and because they are less toxic (24%). Even though only 7% believe that e-cigarettes are not harmful, the majority (42%) of them are 18-24 adults. Harm perception was higher among lesbian (64%) and trans (58%) respondents. The odds of current e-cigarette use decreases among those who believe that e-cigarettes are harmful. The odds of future e-cigarette use decreases among those that believe e-cigarettes are moderately (OR=0.28,p<0.02) or very harmful (OR=0.03,p<0.01). After current users were explained that e-cigarette vapor is shown to contain cancer causing substances, about 50% showed intention to stop using in the future. CONCLUSIONS. Cessation advocates and providers should discuss erroneous perceptions and promote science-based e-cigarette education tailored to the LGBT population.