Recent survey design research has shown that small changes in the structure and visual layout of questions can affect respondents’ answers, but the results are not always consistent across studies. One possible reason for some of the inconsistency may be differences in the item saliency of the questions used in the experiments. In this article, the authors examine how item saliency might influence visual design effects. The authors report the results of three experimental alterations in question format and visual design using data from a 2005 random sample mail survey of 1,315 households. The results suggest that the saliency of the questions has effects both independent of and in concert with the layout of the questions. The implications for survey design are discussed.