The relationship between people’s attitudes toward abortion acceptability and the Supreme Court decision Roe v. Wade, two distinct but related issues, has not been rigorously explored. Using a mixed methods approach, we analyzed in-depth interviews to better understand how participants’ feelings toward abortion acceptability are related to perceptions of whether abortion should be legal. Then, we assessed (i) correlations between abortion acceptability and different measures of support for Roe v. Wade (ii) how the phrasing of survey items related to Roe v. Wade may evoke different responses via online surveys fielded in 2018. Our qualitative results highlight that there is a disjuncture between people’s moral feelings toward abortion and their attitudes toward abortion legality. Our quantitative results further demonstrate that correlations between abortion acceptability and support for Roe v. Wade are not strong, but rather moderate, and the differences in responses to the phrasing of survey items related to Roe v. Wade are moderated by knowledge. When developing survey items, we recommend researchers avoid ambiguities of abortion as a general construct, especially when public opinion measures on abortion are employed for research and the design of social and health policy and practice.