Weather forecasting is not an exact science and, in regions near the southern end of the Appalachian Mountains, the vastly different types of topography and frequency of rapidly forming storms can result in high uncertainty in severe weather forecasts. NOAA created its VORTEX-SE research program to tackle these unique challenges and integrate them with social science research to increase the survivability of Southeast U.S. weather. As part of the VORTEX-SE, this study focused on the severe weather preparation and decision making of emergency management, and in particular, how uncertainty in severe weather forecasts impacted the relationship between EMs and weather providers. We conducted in-depth, critical incident background interviews with thirty-five emergency management personnel across fourteen counties. An inductive, data-driven analysis approach revealed several factors contributing to an added layer of practical uncertainty beyond the meteorological forecast uncertainty that impacted and helped explain the nature of trust in the EM-NWS relationship. No- or short-notice events, null events, gaps in information, and differences in perspectives compared to weather forecasters have led emergency managers to modify their procedures in ways that position them to adapt to unexpected changes in the forecast quickly. The need to do so creates a complex, nuanced trust between these groups. This paper explains how EMs developed a nuanced trust of forecast information, how that trust is a recognition of the inherent uncertainty in severe weather forecasts, and how to strengthen the NWS-EM relationship.