© 2016 American Meteorological Society. The effect of bottom roughness on setup dynamics was investigated using high-resolution observations across a laboratory fringing reef profile with roughness elements scaled to mimic the frictional wave dissipation of a coral reef. Results with roughness were compared with smooth bottom runs across 16 offshore wave and still water level conditions. The time-averaged and depth-integrated force balance was evaluated from observations collected at 17 locations along the flume and consisted of cross-shore pressure and radiation stress gradients whose sum was balanced by quadratic mean bottom stresses. The introduction of roughness had two primary effects. First, for runs with roughness, frictional wave dissipation occurred on the reef slope offshore of the breakpoint, reducing wave heights prior to wave breaking. Second, offshore-directed mean bottom stresses were generated by the interaction of the combined wave-current velocity field with the roughness elements. These two mechanisms acted counter to one another. Frictional wave dissipation resulted in radiation stress gradients that were predicted to generate 18% (on average) less setup on the reef flat for rough runs than for smooth runs when neglecting mean bottom stresses. However, mean bottom stresses increased the predicted setup by 16% on average for runs with roughness. As a result, setup on the reef flat was comparable (7% mean difference) between corresponding rough and smooth runs. These findings are used to assess prior results from numerical modeling studies of reefs and also to discuss the broader implications for how large roughness influences setup dynamics in the nearshore zone.