Temperate reefs host diverse fish communities along the southeast United States Atlantic coast (SEUS), yet the sustainable management of reef fishes faces myriad challenges. One challenge has been the introduction of Indo-Pacific lionfish (Pterois volitans/miles; hereafter "lionfish"), which have spread quickly throughout the SEUS since their introduction in the late 1900s. We analyzed long- term (2001–2019) video data along the continental shelf break and upper slope (45–125 m deep) of the SEUS to assess changes in lionfish densities over time, characterize reef fish community structure, and determine if native reef fish community structure has changed due to lionfish. Lionfish densities increased substantially during the study, from zero individuals observed in 2001 to approximately 1.2 individuals observed per 100 m 3 (and present in all included transects) by 2019, yet no fish community metrics were negatively related to lionfish density. Demersal habitat influenced fish community structure more than any other variable examined, with more individuals and different fish communities occurring on high-relief compared to low-relief hardbottom habitats. The effects of latitude, depth, and bottom temperature on reef fish community structure were generally weak or nonexistent. Although previous empirical work has found that lionfish negatively affect native fishes at small scales (<30 km2), it is unclear why we did not find similar results in our larger- scale study. It may be related to vagaries of the spatial scale of observation, lionfish effects being primarily limited to high- relief habitats, time lags, or lionfish densities not being high enough yet to cause observable ecological effects.