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Grey’s Anatomy Couples: The Top 31 Relationships at Grey Sloan Memorial Hospital

Grey’s Anatomy has been going strong for 17 seasons, and a huge part of its success has to do with the epic, and not-so-epic relationships.

Let’s count up to the best couples on Grey’s, starting with the less-than-stellar and moving to the iconic.

WORST TO BEST GREY’S COUPLES — LET’S DO THIS!

31) Alex Karev and Rebecca/Ava

This was by far the unhealthiest relationship in Grey’s history. Honestly, I feel bad for both of them. Ava wasn’t mentally stable and she tried to convince both herself and Alex that she was pregnant. When her depression overcame her, she descended into the scary region of self-harm. Alex tried his best to comfort her, but he was out of his depth. Ultimately, this was a case of unfortunate timing, and the way mental illness can drive a wedge into a relationship. Certainly not anyone’s fault, obviously, but it ended up being messy and doomed.

30) Maggie Pierce and Jackson Avery

Maggie is one of the sweetest people on Grey’s and Jackson took advantage of her and was TERRIBLE to her. Does anyone else remember when he left her in the car in the middle of a forest. Who does that? Isn’t that how every urban myth about killers with hook-hands begins? Also aren’t they step-siblings too? What in the hell was that move? Narcissism much, Jackson? I’ve eaten sandwiches with more compassion than that.

29) Callie Torres and Penny Blake

I just don’t truly understand how (or why?) they even got together in the first place. Callie was one of the strongest characters on Grey’s and Penny’s well…Penny. Also she played a big part in Derek’s death when she didn’t push hard enough for a head CT. I think the main reason this couple was universally disliked is because we all missed Callie and Arizona and not by land, sea or air could we ever mistake Penny for Arizona.

28) Izzie Stevens and George O’Malley

Honestly, what the hell was this? People always say that guy and girl best friends don’t always like each other in this way, but Grey’s just had to do this to us. Plus there was absolutely no chemistry. I mean zero. Litmus paper comes out dry. No thanks, I’m good.

27) Meredith Grey and Andrew DeLuca

The big problem with this couple for me was DeLuca’s personality. I hated the way he talked to Meredith. Usually in TV shows and movies, the dude is older than the woman so in some ways this should be a victory over the patriarchy and a profound endorsement of a better world where hot young bucks finally appreciate older women for the inspiring earth goddesses they are. But DeLuca is suchhhhhhh a penis. And it’s MER! Come on, people! The show is named after her! You’re gonna pair this fine wine with cold pizza? Hells to the no. Also, in general, I don’t think anyone is good enough for Mer. (Maybe that’s part of the problem!)

26) Mark Sloan and Addison Montgomery

Addison cheated on Derek with Mark. It was never going to be an actual relationship because at that time, Mark wasn’t ready. Too bad for Addison because Mark was as hot as ten jalapeños in an oven. In summer. On Mercury.

25) Mark Sloan and Julia Canner

One of the funniest scenes in Grey’s was when Julia was talking smack to Lexie during a hospital-league softball game so Lex hucked a softball at her and nailed her square in the breasteses. BAM! TAKE THAT, JULIA. Really though, the main reason this couple never would’ve lasted was because Mark was still in love with Lexie. Julia and Mark talked about starting a family; Mark definitely wanted a family, just not with Julia.

24) Derek Shepherd and Addison Montgomery

They had to feel something for each other because they did get married. Then again, Addison cheated on Derek with Mark, oh and then Derek cheated on Addison with Meredith. How much cheating is cool in a relationship? Just wondering. Not trying to kink-shame anyone if lying and skullduggery is your jam, but typically it’s not one of the foundational components of your generic happily-ever-after story.

23) Cristina Yang and Preston Burke

Yuck. Just yuck. I have always hated Burke. He used Cristina when he couldn’t use his hand, and didn’t treat her like the gem she is. Buh bye, Burke! Don’t let the door hit you on the ass on the way out!

22) Callie Torres and George O’Malley

When George told all of his friends he got married and no one was actually happy for him, that really showed that they wouldn’t last. “I DONE GOT HITCHED!”

Crickets.

Oof.

Then Alex made a joke about “Callie O’Malley.” This was not a promising approbation from his peer group. I think Callie was more of an acquired taste in the earlier seasons and definitely got more likeable over time but she still wasn’t fantastic at this point. Also George cheated on her which was awful. Poor Callie. It’s like her particular cross to bear is that everyone cheats on her. She wasn’t great but she definitely didn’t deserve that. Lots of cheating on this show. Too bad they don’t have a Hippocratic oath for monogamy.

21) Maggie Pierce and Winston Ndugu

Yet another relationship that seemed forced in the script and we as an audience just didn’t feel it. Not that there was much to feel. I’m trying to remember how I felt about this relationship, but mostly I’m just getting sleepy thinking about it. This is like the null set of relationships. It didn’t really take away anything, but it didn’t add anything, either. I’m glad Maggie’s happy though.

20) Richard Webber and Catherine Fox

The opposite of love isn’t hate, it’s indifference. So then it’s easy to see how this caustic relationship of rivals could somehow morph into marriage. They both tried to hurt each other. They argued. They disagreed constantly and Catherine bought Richard’s hospital twice, the second time just for spite, which is — let’s face it — what we ALL do when we’re in relationships. If I had a nickel for every multi-million dollar edifice I bought just to stick it to an ex! Hooooo boy! Some of this relationship reeks of fanservice to the older demo of the audience, who still have Nielson boxes next to the rabbit ears on their TVs, but it’s good to see an older couple on a show represented. Go Boomer! It’s ya birthday!

19) Callie Torres and Erica Hahn

This was a monumental relationship for Callie. She figured out that she was bisexual, which is usually a life altering realization if you’ve been dating hombres your whole life. The problem with them was all Erica. She was a bully and I hate bullies. You always hope that the first person you have a relationship with when you start hitting for the other team will be a soft landing place, but it doesn’t always work out that way.

18) Jackson Avery and April Kepner

Jesse Williams, the actor who plays Jackson, is such a peach. Google him. You’ll love him. So it kills me what an asshat Jackson can be on Grey’s. That’s acting, folks! I just don’t think they would have ever worked out. April was very religious and Jackson judged her for that and made a huge deal out of it. Mostly because he was going to burn in hell, am I right fellow Christians? Up high! Just kidding. It felt like they had these rare super sweet moments and the rest was fighting. Jesse Williams is a dreamboat in real life, so it sucks that he’s a kind of a knob on the show.

17) Richard Webber and Ellis Grey

They were both cheating on their significant others with each other. What a novel concept! Great job, Grey’s writing staff! Hey let’s break this couple up, how should we do it? LET’S HAVE THEM CHEAT ON EACH OTHER. Talk about a go-to move. There’s more cheating on this show than a Bill Belichick gameplan. I really think the key problem was that Richard couldn’t leave Adele. He didn’t have it in him and that broke Ellis. (This relationship did make Maggie, though, so net plus, I’d say.)

16) Izzie Stevens and Alex Karev

I have one word to describe this relationship and that word is TOXIC. Alex really tried with Izzie. He took care of her and was good to her, but she skedaddled. Alex was already a broken man but I think that Izzie really messed him up. Also, can we talk about Izzie having Alex’s kids and not telling him? Hiyo! What the hell lady?? Life-altering bombshell much? (Not to mention destroying Alex’s long-term happiness with Jo.) I know, you’re asking why this couple is at 16 when it’s such a hot mess. Basically these are two of the most beloved (Alex) and reviled (Izzie the joy assassin Stevens) characters on the show. Who knows what might have happened if Katherine Heigl had actually showed up to work on the day Shonda was gonna kill her off the show!

15) April Kepner and Matthew Taylor

They’re honestly super cute. Both of them are Christians which is probably refreshing for April after having to deal with biblical heathen Jackson always judging her. Although April left Matthew, you know, at their wedding, she still found her way back to him.

14) Cristina Yang and Owen Hunt

Remember when Owen yanked an icicle out of Cristina? Aww so cute right! This couple was sweet at the beginning but they got super toxic later on. Owen tried to guilt Cristina into having a baby she didn’t want, then cheated on her because he hated her. So not really the healthiest relationship. That said, I cheered from my sofa when she dumped cereal on him. Revenge via Fruity Pebbles is really the best.

13) Teddy Altman and Henry Burton

They were so freaking cute! Henry made Teddy happier than anyone else ever did. They definitely would have lasted but Grey’s had to go and kill him off. Typical Grey’s, right? After losing Henry, every one of Teddy’s relationship arcs morphed into her basically self-sabotaging via cheating. Which is weird, because like NO ONE else ever cheats on this show. It’s like, not done.

12) Owen Hunt and Amelia Shepherd

Owen needs to develop a little executive function and actually ask people what they want before committing to a long term relationship. That tends to lead to a wee bit more stability. The whole thing was honestly weird and they just weren’t right for each other. The other factor in every Owen relationship is that my stupid Gen X parents cheer for him no matter what because he was Lucius Vorenus on HBO’s Rome and he can do no wrong. Au contraire, though, because on Grey’s, Kevin McKidd is not a badass that you can’t hurt. He’s a raw nerve, infinitely woundable.

11) Arizona Robbins and Carina DeLuca

Two gorgeous, charming, and smart women together. Awesome, right? Well I know some people disagree but I found these two adorable together. The only problem was that I missed Callie. Otherwise, chef’s kiss. Check please! We good here. (Carina clearly got all the charisma in the fam.)

10) Owen Hunt and Teddy Altman

Teddy has been in love with Owen for ages now, then she decides to go and cheat on him? This is the brutal and frankly sort of indefensible self-sabotage I was talking about. At some point, the writing staff decided that every human interaction for poor Teddy was going to be a Shakespearean tragedy. I don’t get it. Imagine reaching the finish line of the marathon and then taking steroids? It’s like, whaaaaaaa? You were happy, Teddy. You made it! Her romantic future was cemented and she traded it away for a roll in the hay with good ol Dr. Tom Koracick. I’m not saying he isn’t funny, I’m just saying he’s not blow-your-life-up funny.

9) Meredith Grey and Nathan Riggs

Such a bummer, in a way, because this couple had a lot of potential. Obviously very clearly NOT a bummer for Nathan’s soulmate Megan because she wasn’t dead, but less good for Meredith, who is not Nathan’s designated “soulmate.” Kind of tough for the non-soulmate to usurp the soulmate’s spot. I found it great that they could both confide in and relate to each other because they had both lost their soulmates. But as soon as it was revealed that Megan hadn’t died I knew they were screwed.

8) Izzie Stevens and Denny Duquette

I LOVE DENNY! He was honestly the sweetest dude. Very charming too. Handsome for days, yo. He didn’t deserve what he got and I felt bad for Izzie. (Yes, it’s possible to feel bad for Izzie!) They were really the perfect match and it’s so sad that they didn’t get to spend more time together. Denny was one of the good eggs of the show. A real square G. Basically the polar opposite of the character Jeffrey Dean Morgan plays on The Walking Dead. Negan killed people with bats. Denny killed people with kindness.

7) Nathan Riggs and Megan Hunt

A happy ending. Need I say more? We’re at #7 and this is the first legit happy ending we’ve had so far. People don’t bandy the term “soulmate” around willy-nilly, so when your soulmate returns from across the River Styx, a la Eurydice, even if they were never actually dead, you drop everything and pair back up. Their ending was great. On a beach together instead of Meredith and Derek yelling to each other on a beach and we’re like huh? WTF is happening? Is Mer dead? Why is my face leaking?

6) Miranda Bailey and Ben Warren

Miranda and Ben are the most stable couple on Grey’s. They both know and love each other so much, and it shows. Ben treats Miranda’s kid so well, which is awesome and shows that he’s a mensch. They’ve definitely gone through tough times, but unlike a lot of couples, they come through it stronger. A testament to dedication, hard work and pulling in the same direction in a relationship. You get the sense that in addition to the love, Miranda and Ben actually like each other, which is stellar for long-term effectiveness. #relationshipgoals

5) Callie Torres and Arizona Robbins

CUTE CUTE CUTE! I absolutely loved them as a couple. Their wedding was amazing, they were always so good to each other and should have lasted. The aviation accident really changed Arizona and caused horrible trauma. That’ll tend to happen when, y’know, you crash in a plane and lose your leg. The resulting amputation — performed by Alex with Callie’s explicit consultation — served as a real trigger for Arizona and contributed to the ultimate downfall of the relationship. Goddamn melodramatic Grey’s writing room! This is why we can’t have nice things. The second we think we’re safe, a freaking plane drops out of the sky with doctors in it or a ferry boat obliterates a dock or there’s a bomb in some dude’s chest. That said, I really dug this couple when they were in the honeymoon period and I’ll always love those adorable moments they had together.

4) Mark Sloan and Lexie Grey

Mark and Lexie. Thinking about them always makes me emotional. They were adorable. I really wish they had more time together (that seems to be a common refrain) because their chemistry was amazing and you could tell they loved each other. They would break up for the dumbest reasons and it would drive me crazy to see them with other people when they belonged together. This is a yell-at-the-TV kind of couple where you’re a crazy person in your living room yelling “SERIOUSLY MARK? JULIA? FOR REALZ, GUY?” Whenever they got back together it felt like all was right in the world. One of the notable pairings that had true chemistry and elicited an emotional reaction from the audience at large. In the end, their love story was truly tragic and Lexie’s death will always be one of Grey’s most emotionally resonant scenes.

3) Meredith Grey and Derek Shepherd

I’m going to get dragged for this but there were enough flaws with this couple to keep it from getting number one for me. The biggest one: Derek was an ass. Whenever I rewatch Grey’s I notice how rude and entitled Derek was. He always chose his happiness over Meredith’s. I find it irritating that whenever he had those rare scenes where he was super charming and sweet, people would just forget all the horrible things he did. It was like emotional sleight of hand. Don’t remember my universal arrogance in this hand, look at the nice speech in this hand over here! When Derek died, Meredith grew as a person. She learned that she didn’t need a man to be happy. I have to say though, I’m glad that Derek got to come back and holler at Meredith because he’s been only sweet to her as a hot-ass salt and pepper beach ghost and I’m glad she remembers him that way. (Is it me or does he get hotter as a dead guy?) So I’ll say this: yes, I have officially rained on your parade. Yes, I know you think it’s canon that they’re the de facto top spot. Yes, a case can certainly be made that they’re the best couple. Just not by me, sis. Not by me.

2) Atticus Lincoln and Amelia Shepherd

I’m cheating a little bit on this pick because I’m factoring in Amelia’s whole character arc based on both Grey’s and the spinoff Private Practice. I watched her fall in love on Private Practice and then witnessed her pain as she tried to cope with that love dying of an overdose. Her life was established as hellish: riddled by doubt, addiction and depression, which was tough to watch. Her family was so toxic. Ugh. It put me at ease to see her in a stable, loving relationship on Grey’s. Plus she finally got to have a baby! Wooo hoooooo! Link is the nicest dude on the show and he treats Amelia like the queen that she is. They’ve both had very challenging lives and it’s just so great to see them happy. Chalk up another happy ending so far, at least. (There are so few of them!)

1) Alex Karev and Jo Wilson

It’s hard for me to put in words how much I love this couple. Alex started out as a selfish ass, and became a total sweetheart. I’m not sure how much actor Justin Chambers paid the writing staff to have the best character arc on the show but it was money well spent. Alex also had to deal with a ton of crazy people who took advantage of him, which I was sick of seeing, so when he got together with Jo and built something so pure, it felt like a breath of fresh air.

Then there’s Jo, who had been running her whole life and was never treated as well as she should have been. When they found each other it was serendipitous. Alex always supported Jo and they had a blast together. The chemistry between them was palpable. You can do all those online Grey’s personality quizzes and I always come up Jo, which is cool because I relate to her more than anyone. So to see her finally be appreciated and loved made me feel great. Maybe my Alex is out there, looking for his Jo! Their wedding episode will always be my all time favorite Grey’s episode.

Now let’s get to the difficult part…Izzie. Ugh! Cue thunderstorms and dark clouds. Why does Izzie have to ruin everything good? My opinion is that Alex would never ever leave Jo, especially not for Izzie, so that whole storyline seems flawed. I definitely think that Izzie kidnapped Alex and he’s trapped in her basement. Izzie’s a menace. Alex! Blink twice if you need us to call 911! Not a fan at all of this storyline. Alex and Jo belong together!

I hope you’ve enjoyed my take on all these couples! Jump into the comments to share your two cents. Thanks for reading! It’s a beautiful day to save lives!

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