Research involving student and tutor responses to a ‘pedagogy of the heart’ approach in a first year university health science topic revealed anxiety, insecurity and perceptions of unpredictability in relation to an innovative arts-based assignment designed to elicit and assess experiential or imaginal knowledge. Using the lens of contemporary theories of risk, and explicitly considering the role of emotion in assessment, this paper identifies both the effectiveness of and challenges encountered in this form of assessment. It also explores the relationships between risk and emotion, and between risk and assessment, particularly for young people in the higher education context. By comparing the risks involved with the benefits to be gained, the efficacy of adopting such a pedagogical approach is reviewed.