© 2015 American Meteorological Society. High-resolution observations from a 55-m-long wave flume were used to investigate the dynamics of wave setup over a steeply sloping reef profile with a bathymetry representative of many fringing coral reefs. The 16 runs incorporating a wide range of offshore wave conditions and still water levels were conducted using a 1:36 scaled fringing reef, with a 1:5 slope reef leading to a wide and shallow reef flat. Wave setdown and setup observations measured at 17 locations across the fringing reef were compared with a theoretical balance between the local cross-shore pressure and wave radiation stress gradients. This study found that when radiation stress gradients were calculated from observations of the radiation stress derived from linear wave theory, both wave setdown and setup were underpredicted for the majority of wave and water level conditions tested. These underpredictions were most pronounced for cases with larger wave heights and lower still water levels (i.e., cases with the greatest setdown and setup). Inaccuracies in the predicted setdown and setup were improved by including a wave-roller model, which provides a correction to the kinetic energy predicted by linear wave theory for breaking waves and produces a spatial delay in the wave forcing that was consistent with the observations.