vulture lists

Every Couple on Grey’s Anatomy, Ranked

Photo-Illustration: Vulture and Photos by ABC

This list was originally published in 2018, but there’s been a lot of Grey’s Anatomy relationship drama since then. For Valentine’s Day, we’ve updated the ranking to include fresh couples and reevaluated the romances that came before.

On Grey’s Anatomy, love is always in the air. Like a contagious disease to which surgeons, nurses, paramedics, and patients have all fallen victim, from which no one at Grey Sloan Memorial is safe. Love will find you! And over the course of more than 400 episodes, love has found pretty much every character that has graced those hospital halls — most of them more than once. You’d think all these elite surgeons would be busy saving lives, but no. These people are also elite multitaskers. Fans of Grey’s Anatomy have been privy to every type of couple — romantic, tragic, toxic, short-lived, on again, off again, or enduring — and now it’s time to rank them.

But before we get into whose flame burns eternally and whose we wish had never been lit at all, some ground rules: We’re only talking couples that feature at least one employee of Grey Sloan Memorial (née Seattle Grace). It has to be more than just platonic hooking up (sorry Callie and Mark, Cristina and Shane, Jackson and Jo, and … whew, there are a lot of friends with bennies on this show) or obvious attraction with no real action (what could’ve been, Meredith and Cormac!), and we have to see some of their relationship play out (Cristina and Dr. Marlow and Jo and Paul Stadler are out).

This ranking is not necessarily about who is the happiest, healthiest couple. In fact, there are some couples high up on this list that were not healthy at all. (Look away, therapists!). Making each other happy is a sure way to win some points and move you up the list, but also factoring into this ranking is chemistry, importance to the Grey’s Anatomy canon, and how compelling their love story is overall. Did they make us groan whenever one of their storylines took top billing in an episode, or did we swoon? Were they memorable regardless of how short (or terrible!) their stint together was or will we have to go look them up after reading this? When the O.R. lights finally go down in Grey Sloan, which couples, for better or for worse, will stand the test of time?

64. Jo Wilson and Jason Myers

As if Jo Wilson needed another terrible man in her life after she escaped a marriage of domestic abuse. Unfortunately, the guy she chooses to date in order to make Alex Karev jealous is also abusive. Jo fights back and puts him into a coma. After Alex threatens his life and career, the ob-gyn is never seen or talked about again. It’s better that way.

63. Izzie Stevens and Hank the Hockey Player

Okay, this relationship doesn’t survive the first five episodes, but per the rules, Hockey Player boyfriend must be mentioned. What a dope! Izzie is better off without him. The guy doesn’t get her medical-internship life and is barely memorable. Hank is but a blip.

62. Maggie Pierce and Clive/Jackson Avery and Priya

I’m putting these two couples together because they were both minor pit stops on the way to Maggie and Jackson getting together. Priya, a human rights lawyer, was always too good for Jackson and the drama of Grey Sloan. Clive was kind of cool until his wife showed up. Wives, am I right?

61. Arizona Robbins and Eliza Minnick

Arizona Robbins has chemistry with pretty much everyone. (How many hot lesbians have shown up and immediately fallen in love with her?) So it is confusing when she has zero chemistry with the universally disliked Dr. Minnick. Arizona needed some romance but THIS WAS NOT THE WAY.

60. Maggie Pierce and Ethan Boyd

Radiologist Ethan Boyd is Maggie’s first foray into the Grey Sloan dating pool. He’s very cute and patient, but this fizzles out pretty quickly. Not long after, Ethan ends up getting married and Maggie seeks comfort in Andrew DeLuca’s arms. Everybody wins!

59. Alex Karev and Lucy Fields

Lucy is Alex’s first real girlfriend after the one-two punch of Rebecca/Ava and Izzie. It all seems like a nice, normal relationship until Lucy goes and steals Alex’s opportunity to work in Africa. There wasn’t a ton of passion here to begin with, but still, that’s cold.

58. That intern love triangle from season five

Okay, okay, their names are Pierce, Megan, and Steve, but does anyone even care? All they really do is cause Meredith and George a whole lot of trouble for one day as they sort out their drama. In the end, Megan is in love with Steve and pregnant with his baby and eventually they get married. Good for them, inconsequential to us.

57. Meredith Grey and William Thorpe

On paper, Thorpe is great. He’s a soldier who is also a surgical oncologist. He is a hunk with a dark side. He is cool with going on a date that consists of simply eating French fries in his car. Unfortunately, he shows up much too early. Meredith is nowhere near ready to begin dating after losing Derek. Thus, Thorpe’s time is short-lived.

56. Owen Hunt and Emma Marling

Emma is perfect for Owen! She is sweet and kind. She is an excellent maternal-fetal surgeon. She volunteers to cook Thanksgiving dinner even though we all know that is legit crazy. She also wants to have a family. Which, to our knowledge, is all Owen has ever wanted in life. It’s what drove an insurmountable wedge between Owen and Cristina. Only, when Emma tells Owen that she’d like to have three kids and she’d leave her job to raise them, his brain is mysteriously replaced with that of a coldhearted alien. He thought he wanted kids, but now what he wants is a partner who is just as committed to her job as he is. Owen is insufferable in this moment and Emma, girl, you’re better off without the guy.

55. Mark Sloan and Julia Canner

Well, this is a unicorn: Mark Sloan in a stable, adult, non-tragic relationship. Julia is a talented eye surgeon who loves Sofia, loves Sofia’s moms, and loves Mark. They even start talking about building a family together — all of Mark’s dreams are coming true. Except all of Mark’s dreams include Lexie. These two are technically still together when Mark and Lexie’s plane crashes, but even if that didn’t happen, Julia never stood a chance against Lexie.

54. George O’Malley and Olivia Harper

The worst thing about this relationship is not that Olivia gives George Alex’s syphilis. The worst thing is that George ends it by saying, “I like you, Olivia. I just don’t like you enough.” That is way harsh.

53. Teddy Altman and Andrew Perkins

For two hot people, this relationship sure is a snooze.

52. Jo Wilson and Todd Eames

Todd sings when he orgasms, so, like, you can guess how this went.

51. Jackson Avery and Vic Hughes

This always felt more like a mechanism for Grey’s Anatomy/Station 19 crossovers (they really love their crossovers, don’t they?) than it did a relationship to root for. Vic had just watched her fiancée die in a devastatingly emotional storyline, and Jackson had just gotten out of his very complicated relationship with Maggie. Neither were ready to get into something real and it showed!

50. Arizona Robbins and Leah Murphy

If you were asking Arizona, she would say this was just a rebound hookup after Callie. If you were asking Leah, she’d say they were on the verge of getting married. It was a very messy affair that was most memorable for leading to a much-needed reckoning at Grey Sloan in regards to so many attendants sleeping with interns. Seriously, it was like it was part of the residency program or something.

49. Miranda Bailey and Tucker Jones

We never really get to see the romantic side of Bailey’s first marriage, only its destruction. Tucker isn’t around much, but the relationship is extremely important to Bailey’s character development. She was pretty broken post-divorce (what kind of man gives Dr. Miranda Bailey an ultimatum?!), and you can still see those effects today. Bailey learns a lot about herself through her time with Tucker, getting her ready to meet the true love of her life (squeeeee), and we as an audience get to see a more vulnerable side of her for the first time.

48. Carina DeLuca and Maya Bishop

If this were a list of Station 19 couples, Carina and Maya would be close to the top. They’re iconic and complex and have a wild amount of chemistry! This, however, is a Grey’s Anatomy list, and something tells me most Grey’s fans wouldn’t even know Maya’s name. Most of their relationship has played out on the spinoff, especially once Stefania Spampinato jumped ship from Grey’s ahead of season 17 to become a series regular on Station 19 during their fourth season.

47. Callie Torres and Penny Blake

Was Penny’s greatest Grey’s sin that she didn’t fight hard enough to get Derek a CT scan, effectively murdering him? Or that she showed up at Grey Sloan, started dating Callie, and turned the doctor we’ve known since season two into a completely different person — one who would put everyone (audience included) through a terrible custody battle so that she could move across the country to be with someone she has no chemistry with? Killing Derek is bad, but the latter is straight-up ridiculous.

46. Owen Hunt and Amelia Shepherd

At one point, early in Owen and Amelia’s relationship, Owen says, “I won’t survive another plane crash, Amelia. And that’s all that we are.” Amelia and Owen are two broken people running from pain and loss who find one another. Sometimes that can be romantic. This time, however, Owen’s right: It’s just a plane crash. The show attempts to retcon the entire shrieky relationship by blaming all of Amelia’s actions on a brain tumor she’d had for ten years, but that somehow makes it worse. Relationships, as this show proves, can be tragic and romantic, but there’s nothing emotionally moving about watching a couple who make each other miserable the entire time they are together.

45. Owen Hunt and Teddy Altman

The first draft for this blurb was just “AGHHHAFFHHHHGHHHHNOOOOO,” and while I know in my heart all Grey’s fans would see that and be like, Yes, I am with you, I’ll elaborate. Have two people meant to be so right for each other ever ended up being this wrong? Even back in Teddy’s original Grey Sloan (then Seattle Grace) stint during seasons six through eight, it seemed like these two couldn’t go more than a few episodes without fighting. When she showed up again in season 14, pregnant with Owen’s baby, the fighting picked up right where they left off. Could the Grey’s writers lay off a little? There’s bountiful chemistry and these two have a history that makes for what could be one of the most compelling romances on the show. Just let them go like half a season without someone sex butt-dialing the other or becoming a fugitive from the law. Is that so much to ask? So, why aren’t they dead last on this list? Because we might not enjoy our time with them, but we will never forget they existed! #WouldIfICould

44. Izzie Stevens and George O’Malley

Hard pass.

43. Amelia Shepherd and Atticus Lincoln

I was really onboard with this pairing in the early days when they were first eating donuts and having sex (in whichever order they saw fit!), and that is saying something for me, a person with a lot of notes for Amelia Shepherd. At the start, they seemed pretty swoony, plus, Amelia was all about taking things slow for once. And then she got pregnant and refused to tell Link who the father was. Things got complicated, but they stuck it out through the pandemic. Then, one day, Link made the tragic mistake of proposing to Amelia in public by way of tiny children, during someone else’s wedding no less. Honestly, he was asking for the heartbreak. Their breakup was prolonged and unbearable, which are two super fun adjectives, and I hope they never, ever attempt another go at things.

42. Derek Shepherd and Nurse Rose

If I were the fanfiction-writing type, I’d be writing novels about how one day the very nice Nurse Rose runs into a very nice veterinarian named Finn and they laugh and laugh about how they ever thought they had a shot at breaking up the eternal love of Meredith Grey and Derek Shepherd and then they fall in love and have very pretty children and probably three dogs. Rose and Derek seem pretty great together, but come on. Let’s all be honest with ourselves here.

41. Mark Sloan and Teddy Altman

The good doctors Sloan and Altman enter into this short-lived relationship wanting completely opposite things: Sloan, urged by BFF Callie, is looking for a serious, adult relationship that includes dates in the light of day. Teddy just needs a good lay. Fortunately, they both get a little of what they want! The sex is good, the daytime conversations are surprisingly nice, but ultimately these two aren’t very compatible.

40. Jackson Avery and Maggie Pierce

It seems like a bad sign for a couple when characters have to repeatedly explain that they are only sort of step-siblings, as if the writers were already anticipating the pairing not going over well with the audience. These two only sort of step-siblings had some steamy moments, but I’ll mostly remember them for their breakup: Maggie calls Jackson “Mr. Monopoly,” and Jackson wanders off into deadly fog rather than be around her for one more minute. They were fine.

39. Callie Torres and George O’Malley

Pro: Callie was Callie O’Malley for a little bit and that is hilarious. Con: The chemistry between George and Callie was always a little bit off. Callie pretty much spent the entirety of this relationship telling George she loved him and not getting a response, dealing with judgy looks from George’s judgy friends (I love them, but they are judgy), helping George deal with the death of his father, and then getting cheated on by George. Callie got a raw deal, you guys.

38. Callie Torres and Erica Hahn

Callie and Erica are important because their relationship helped Callie come out as bisexual and also because it meant we got to see Mark Sloan repeatedly ask for a three-way. He’s a dog, but he’s our dog! There was chemistry between them, obviously, but Erica was never THE ONE for Callie. So when Hahn walked off into the Parking Lot of the Unknown, it wasn’t a huge loss.

37. Lexie Grey and Alex Karev

You know those things where while the thing is happening you are super okay with it and it seems like it works and then you think back on that thing years later and you’re like, “Holy hell, that seems like a terrible idea, why would I ever do that?” That’s pretty much Lexie and Alex.

36. Stephanie Edwards and Kyle Diaz

This doctor-patient relationship is the mini-version of Izzie and Denny. Stephanie and Kyle don’t get as much time or focus, but they have a similarly intense connection. These two are so good together, even knowing that Kyle’s a goner from the moment we meet him doesn’t ease the pain when he finally dies in surgery after complications from his MS. It is brief but swoony!

35. Teddy Altman and Tom Koracick

When Tom Koracick was first introduced in season 14, it would’ve been impossible to think you’d ever be able to feel bad for the guy who constantly reminded us of how talented he is and how many women he’s slept with. Then he got sucked into the Owen/Teddy Vortex of Pain and, well, here I am feeling bad for the guy. Teddy and Tom started dating while Teddy was pregnant with Owen’s baby, so it was always complicated, but come on, the man was building baby furniture for her! This man! Unfortunately, even though these two were kind of good together, Teddy chose Owen over Tom time and again. It’s a real shame. Did you hear the part about the baby furniture?

34. Andrew DeLuca and Sam Bello

Wow, what a real turn around here! Admittedly, I originally wrote off DeLuca and Bello as a mostly annoying couple who, based on their deep history of emotionally destroying each other, should avoid one another at all costs. But just as these two were making a much more mature go of things, Bello, a Dreamer, has to flee to Cristina’s institute in Zurich in order to avoid being deported to El Salvador. Who among us did not shed a tear while watching DeLuca have to say good-bye to his first great love as she pulled away in a taxi? Okay, so I guess in the end they still destroyed each other emotionally, but, like, in a less annoying, more tragic and moving way.

33. Jo Wilson and Atticus Lincoln

Okay, these two haven’t technically been in a real relationship yet, but while they might have publicly considered themselves sad friends with benefits, there were a whole lot of feelings involved. Jo is in love with Link! And then, once she told him the truth and decided to end it, Link caught those feelings. They’re best friends, they’re both heartbroken, they are single parents, they are living together, they are in love with each other — we all know the official label is inevitable. Just get back together and call it what it is, guys!

32. Alex Karev and Rebecca/Ava

I am very much here for inappropriate doctor-patient love stories, but Alex and ferry-boat-crash victim and facial-reconstruction patient Rebecca-also-Ava was always a disaster. It made sense that Rebecca would deal with the intense amount of trauma she faced by falling for Alex, but Alex should’ve known better. Especially when she starts showing up out of nowhere and convinces Alex (and herself) that she’s pregnant, but is clearly not. Poor Alex! Poor Rebecca/Ava! This relationship was never going anywhere, but it’s also hard to forget.

31. Maggie Pierce and Andrew DeLuca

Like Tyra Banks before me, I was rooting for them. It was good for by-the-book Maggie to spend some time shtupping an intern. He ends up breaking things off because people treat him differently once they know he’s an intern sleeping with the head of cardio, but it was fun while it lasted, and fun is a hot commodity around Grey Sloan, a true beacon for tragedy.

30. Stephanie Edwards and Jackson Avery

This is another Grey’s couple that, aside from an intern dating her boss, seems perfect on paper. But Jackson’s heart is never truly in this, and as a result, it’s hard to root for. They are only memorable for how they ended.

29. Miranda Bailey and Eli Lloyd

Let’s call this one How Miranda Bailey Got Her Groove Back. Eli leaves Bailey dirty notes in charts, introduces her to the wonders of the on-call room, he makes Bailey laugh. No-nonsense Bailey! Not to mention, Hot Nurse Eli is extremely good at his job, has the voice of an angel, and is very much there for Bailey when she gets upset after a plane crashes in the Sound. Eli is great and should he make a surprise return to snatch up some other eligible doctor, I would not hate that.

28. Meredith Grey and Finn Dandridge

Oh, McVet. McVet is a very nice man who can heal animals. McVet is very handsome. But McVet is only an obstacle. McVet is a plot device to prolong the inevitable reunion of Meredith and Derek. McVet is very dreamy but he isn’t McDreamy, you know?

27. Arizona Robbins and Carina DeLuca

Two hot people sleeping together and working to fix the maternal mortality rate in the United States? That’s a trajectory for iconic couple status. Alas, the two end things when Arizona decides it would be in her daughter’s best interest to move to New York, where Callie is. A lot of wasted potential here!

26. April Kepner and Matthew Taylor

Matthew Taylor must rue the day he met April Kepner. First, she ditches him at the altar to be with Jackson. Then, his wife, Karin, dies in childbirth at Grey Sloan (with April lurking around). THEN they fall back in love, claiming they now understand each other’s pain, having both suffered tragedies, and impulsively get married. AND THEN we learn that they split up because there was too much hurt and guilt there (no, and I can’t emphasize this enough, duh). These two are memorable for all the wrong reasons.

25. Meredith Grey and Nathan Riggs

Grey’s Anatomy tried real hard to get Meredith a post-McDreamy love, and as the Meredith and Riggs romance showed, maybe a little too hard. Nathan was a great character, and their hookup in the hospital parking lot was [insert chef’s kiss], but their greatest commonality was the grief they were still feeling for their respective soul mates. This was always a relationship of four people. Thankfully, it ends in exactly the right way.

24. Lexie Grey and Jackson Avery

Lexie and Jackson, beautiful humans and capable doctors, get together during one of Lexie’s numerous breaks from Mark. There was never much hope for them, which is a shame because they are a great pairing. Plus, it starts out with Jackson saying dreamy things about how there’s a line of guys waiting for Lexie if she would just get over Mark, and he is most definitely in that line. Also, laundry-room sex! Alas, the power of Mark Sloan was too great to make this work, but in a surprise twist, it is actually Jackson who chooses Mark over Lexie — the Plastics Posse is more important to him than fighting for a woman who doesn’t really want to be with him anyway. The Plastics Posse. Now that’s true love.

23. Amelia Shepherd and Kai Bartley

We’ve been burned by Amelia Shepherd before, so it’s hard to get too invested this early on — Amelia and Kai met in season 18 during Meredith’s Parkinson’s study — but so far, so good? Amelia has never felt so seen in a relationship and Kai is so in love they’re willing to throw their “no kids” rule out the window. Maybe these crazy kids just might make it. Maybe.

22. Meredith Grey and Andrew DeLuca

Listen, Andrew whispered in Meredith’s ear in Italian while they were on an elevator. What’s a girl to do? We know elevators are Meredith’s aphrodisiac! This might be controversial to say, but I enjoyed these two as a couple. He loosened her up a little and for her first real, “I love you” relationship post-Derek, you couldn’t ask for more than a man who adores her. Still, it was always doomed: As Andrew figured out, Meredith never saw him as her equal. Plus she didn’t seem that upset when he got shanked by a sex trafficker and died (RIP, my man!), so it really wasn’t going to last long term, you know?

21. Nathan Riggs and Megan Hunt

Didn’t we almost have it all? I know Nathan and Megan are two very minor Grey’s characters in the grand scheme of things, but they were given one of the most emotional love stories of the series. After ten years, Megan Hunt turns up alive and she and Riggs are still very much in love. It’s a testament to the show and to Martin Henderson and Abigail Spencer that people were so invested. They get their big, happy ending as they head off to build a life on a sunny beach in California. They were standing there, holding each other in the waves! But not even these two can escape the wrath of Grey’s Anatomy: In season 18, Megan and her adopted son show up for Owen and Teddy’s wedding and she casually informs us that she and Nathan didn’t make it through the pandemic. To what end?! Who does this serve?! I am still so mad about this!!

20. Maggie Pierce and Winston Ndugu

Maggie and Winston, former colleagues in Boston (okay, she was his boss), have only been together since season 16, so we’ve yet to figure out what kind of impact they’ll have large scale, but dang are these two easy to root for. They reunite at a medical conference and spend the entire day and evening together, Before Sunrise style. It’s lovely! Most of their problems stem from the fact that they got married quickly and it probably doesn’t help that most of the time Winston seems more in love with Maggie than the other way around. Still! These two get each other, and my fingers are crossed that they iron all the little marital wrinkles out.

19. Levi Schmitt and Nico Kim

Schmitt and Nico have had some very memorable moments. A steamy one: hooking up in the back of that ambulance during the wind storm. A swoony one: when Schmitt needed time to figure out his feelings and he shows up at Nico’s place to find that Nico’s been making his apartment cozy and lighting candles every night in the hopes that Schmitt might come by so he could tell Schmitt that he loves him. And a romantic one: Nico says all he wants to do is watch Lord of the Rings with Schmitt, even though previously he had said he’d “rather stab [his] eyes out with a fork.” That’s love. Unfortunately, most of the time when these two are together, all I can think about is how Schmitt deserves so much better. Nico has made Schmitt feel bad about himself too many times and hasn’t always been the support system Schmitt’s needed. Schmitt dumps Nico during a real low, but let’s hope it sticks and Schmitt moves on to something better. Thanks for coming to my Ted (Schmitt) Talk.

18. Cristina Yang and Owen Hunt

It starts with a violent PTSD episode, in the middle they get married for all the wrong reasons (although Cristina’s red wedding dress is so, so right), and it ends over and over again because they love each other but want different things. This may be a controversial placement on the list because this relationship was such a big part of the show, but did Cristina and Owen ever seem that happy together? Their breakups and makeups grew repetitive, especially since neither were ever going to change who they really are.

17. Cristina Yang and Surgery

The purest love depicted on this show.

16. Derek Shepherd and Addison Montgomery (Shepherd)

Even when these two hate each other, they are good together. They are hotties. They have history. Their chemistry is off the chain, as the kids say. However, as Addison so eloquently puts it while she and Derek are attempting to make their marriage work: “The only people who don’t know Derek and Meredith are in love are Derek and Meredith.” This couple is another that falls victim to the unstoppable force of Meredith and Derek’s story. The only difference: This one really hurts. In some alternate universe, Derek actually fights just a tiny bit for Addison and those talented beauties make things work. I’m not saying I want to live in that universe, I’m just saying it exists and that’s nice.

15. Mark Sloan and Addison Montgomery

Am I cheating a little because Mark and Addison were never, at any point “official” official? Sure. But Mark and Addison are such an integral, iconic Grey’s pairing that it felt wrong not to include them. Plus, they were straight fire together.

14. Teddy Altman and Henry Burton

Please don’t make me talk about this one, it happened way back in season eight, but I am still not over it. Teddy and Henry are your typical “boy has chronic illness and no health insurance, boy meets doctor with health insurance, boy and doctor get married for insurance reasons, boy and doctor fall in love, boy dies” tragic romance story. They get precious little time together, but even so, they are one of the most supportive, loving couples in the show’s history. Henry is inspired to go to medical school, and even though Teddy hates the idea, she promises to have his back. Henry makes Teddy happier than we’ve ever seen her, thank you very much, Owen Hunt. They are in such a lovely place when Henry suddenly dies on Cristina’s surgical table. WHYYYYY. Teddy and Henry weren’t together long, but boy, were they memorable.

13. Alex Karev and Jo Wilson

What do you even say here? It’s tricky because so much of the way this relationship — a major one for the series — ended was mostly an “it is what it is” situation. Justin Chambers abruptly left the series in season 16 and there were only so many ways to write off his character. Knowing that, however, didn’t make it any easier to see him ditch some well-earned character development and the wife he promised to always be there for in order to start a life with Izzie Stevens (!!). Alex and Jo weathered so much together and it seemed like they were fighting against all odds for a happy ending. Alex had become so mature! Jo had become mostly tolerable! These two abandoned souls who found one another seemed poised to become a long-term, foundational Grey’s couple. Who did not tear up during Jo’s “you are my home and you are my heart” proposal? Alas, it is what it is. Hey, we’ll always have that one time they made out against a barn.

12. Richard Webber and Adele Webber

Does anyone not tear up just thinking about the time when Adele, suffering from Alzheimer’s, is having an episode in the hospital, and Richard, in the middle of surgery, sings “My Funny Valentine” to her while she stands crying in the OR gallery, in order to calm her down? BRB, I have something in my eye.

11. Meredith Grey and Nick Marsh

When Meredith first met transplant surgeon Nick in season 14, she saves his life after he has some complications from a recent kidney transplant. But he does something important for her, too: Through their day of flirty banter and heart-to-hearts, she, for the first time, feels like there could be love after Derek. But it’s not their time. They don’t cross paths again until season 18. The connection is instant. The chemistry, undeniable. To see Meredith this happy again is pretty freaking great. Seriously. Sure, no one will ever replace the Meredith and Derek of it all, but if Meredith is going to ride off into the sunset with anyone else, it’s kind of nice to see her with someone who understands who she is now after, well, everything.

10. Izzie Stevens and Denny Duquette

The doomed doctor-patient love story of Izzie and Denny helped make Grey’s Anatomy what it was back in the early days. Millions of people know what an LVAD wire is because of Izzie and Denny. Their chemistry was so palpable and their tragic ending was so obvious that you couldn’t help but get wrapped up in their romance. Their entire relationship happens inside the hospital walls, but it feels so fully realized that you kind of forget. Izzie should know better, but when Denny responds with a dimply smirk and a “good luck with that,” who can blame her? We all fell for Denny. Even though it’s clear that Denny is a goner, his post–heart transplant “I get to choose now and I choose you, Izzie Stevens” speech is so romantic that you hope that the show gives Denny a last-minute reprieve. Although, if you’re honest with yourself, Izzie and Denny are such a memorable Grey’s couple because he dies. Cruel but true!

9. Callie Torres and Arizona Robbins

This relationship is a tough one. It’s one of the longest on Grey’s Anatomy. It is the show’s first long-term same-sex couple. Callie and Arizona make each other better people … until they don’t. The two are never the same after Arizona loses her leg in the plane crash. They fight admirably to save their marriage, but only end up hurting each other over and over again. Let’s be real: A lot of it is Arizona hurting Callie with a whole heap of guilt for taking her leg (and saving her life!), plus an affair to boot, and Callie taking it like a punching bag. Their divorce was one of the most brutal storylines to wade through on this show (and that is saying something). And then, when Grey’s decided to (stupidly) ditch Arizona, it sends her off to New York, where it is heavily implied that Arizona and Callie get back together. Such high highs really gave way to some seriously depressing lows. It’s great that they found each other again in the end, but they deserved a better path to get there.

8. Mark Sloan and Lexie Grey

Mark and Lexie are undoubtedly Grey’s Anatomy’s star-crossed lovers. They are each other’s destiny, but just can’t seem to work out the timing. It remains tragically off until the very end. After years of their on again-off again relationship, Lexie works up enough courage to give her big “I can’t sleep, I can’t eat, I can’t breathe” speech to Mark to finally win him back, only to die days later in a plane crash. Mark follows soon after. So, in this life, they never work out. But on Meredith’s Death Beach, she envisioned Lexie and Mark together again … so maybe in the next?

7. Richard Webber and Ellis Grey

Would we even be here if it weren’t for Ellis and Richard’s forbidden love affair? We do get to see their love (and heartbreak) on display in flashbacks, but the true testament to their connection comes when Ellis, afflicted with Alzheimer’s, sees Richard at the hospital and lights up. Richard is the only person who can calm her. When she returns to the hospital in a rare lucid episode, they get to say things they weren’t able to before. Richard doesn’t regret staying with Adele, but he also understands that telling Ellis this won’t help her situation. Instead, he holds her and tells her about the wonderful, happy life they would have had together. And then suddenly, she is gone again. Yes, this relationship is an affair, and it was wrong for Ellis and Richard to do this to their spouses, but that doesn’t make their love any less true, tragic, or memorable.

6. Cristina Yang and Preston Burke

Come at me! Cristina and Burke are only together for around two seasons before he dramatically leaves Cristina on their wedding day (let’s be honest: Burke was always a drama queen), but they are such a part of one another and such a part of this show, they blow so many other couples out of the water. He somehow makes a yellow turtleneck hot as he spoons Cristina after her surgery for an ectopic pregnancy. Cristina puts her career in jeopardy to help Burke hide his hand tremor after he’s shot. THEY DANCE IN THE KITCHEN TOGETHER. They are Cristina and Burke! She has other (longer) relationships, but Burke is so much a part of who Cristina is as a woman and a surgeon that when he pops up in season ten to lure Cristina away from Seattle, it just feels so right. No, they don’t end up together, but they are forever connected.

5. Richard Webber and Catherine Avery

Everyone is encouraged to go back and watch “Moment of Truth” in season eight, when Richard and Catherine sleep together for the first time. A hot sex scene featuring two characters over 50? Very refreshing, Grey’s! Richard and Catherine are such a great couple because they are so evenly matched. They both love and respect one another, which is what makes their separation in season 16 so devastating, because so much of their problems is born from losing that respect for the other. But who among us has not had a little marital spat over one person buying an entire hospital just to humiliate the other? But a cobalt poisoning and a pandemic really put things into perspective for these two, and now they are back and stronger than ever. There is romance and flirtiness and real, loving support for one another. And if they don’t stand the test of time now, Grey’s, heads will roll.

4. Jackson Avery and April Kepner

Well, well, well, what do we have here? Is that Japril being endgame against all odds?! Japril may be a divisive pairing at large, but on this list? On this list we are pro-Japril always and forever. Their hookup in the bathroom during their oral boards in season eight is one of the hottest scenes in Grey’s Anatomy history, period. It also doesn’t get much swoonier than Jackson standing up and professing his love for April at her wedding. “Say it loud and go from there!” They were broken people after the tragic loss of their son, Samuel, but survived a kitchen table C-section (hello, Harriet!) and remained each other’s best friends even as they went on to date other people. I’ll never forget the look on Jackson’s face when he first sees April, nearly dead on the OR table in season fourteen. While Grey’s Anatomy may have botched April’s exit (marrying Matthew, are we kidding?), at least they had enough courage to fully trash that and have them reunite as Jackson decided to leave Seattle to take over the Catherine Fox Foundation in Boston. They always found their way to one another. The on-screen chemistry between Jesse Williams and Sarah Drew makes Japril undeniable, and the fact that Grey’s Anatomy set aside not one but three Japril-centric episodes to explore their relationship makes them iconic.

3. Izzie Stevens and Alex Karev

When Izzie walked away from Alex and Seattle Grace back in season six, if you had said that one day the two would reunite, you would’ve sounded batshit crazy. And yet here we are. What a world! Sure, Izzie and Alex ending up together — with two kids — only happened because of an unpredictable real world situation (but for why, Justin Chambers?) and yet, it still feels right. Okay, at first, it felt very wrong. Alex leaving Jo with zero warning or explanation — they were in a very healthy place! — made very little narrative sense. But wanting to give Alex and Izzie a happy ending? I get that. In a perfect world, seeds would’ve been planted, leading Alex back to his ex-wife. We would’ve gotten the slow burn reunion this epic romance deserved. But there was no time for planting or slow burns. However, even before their controversial ending, Alex and Izzie deserved to be held in high regard in Grey’s Anatomy Coupledom. Meeting as interns, the two were given your classic enemies-to-lovers arc. They endured a whole lot of ups and downs and Georges and Avas, but eventually realized that they were the best version of themselves when together. Alex’s “you make me better. You make me want to be better” speech? It still makes me tear up. Alex lifting Izzie, in her prom dress, up off of Denny’s body and holding her as she weeps? Iconic. Their wedding while Izzie was on the verge of dying from cancer?! An ugly cry for the ages! I might hate the way they ended up together, but I sure do love that after everything, they found their way back to one another.

2. Miranda Bailey and Ben Warren

Miranda and Ben are both the longest running and arguably the best example of marriage Grey’s Anatomy has. Yes, they’ve had some low points — Bailey’s OCD, Ben doling out a fatal C-section, all the church-and-state stuff, the miscarriage, Ben’s decision to become a firefighter leading to a brief separation — but they always bounce back. If you had any doubt, their scene after Bailey comes out of heart surgery and Ben sees her for the first time is so full of emotion and love, I’m actually crying while typing this. She is our mom and he is our dad. And talking about how wonderful and loving their marriage is doesn’t even touch on how wonderful and loving their courtship was. Ben is able to push and encourage Bailey in a way others can’t, and Bailey helps keep Ben levelheaded. They just fit. Richard Webber put it best when he said, while lamenting about a rough patch in his own marriage, “Not everybody’s Bailey and Warren.” No they are not, sir! No they are not!

1. Meredith Grey and Derek Shepherd

As if anyone else had a chance. Meredith and Derek are so much a foundational part of Grey’s Anatomy that when Derek died in season 11, people were fearful of how the show would go on without them together. I mean, obviously Meredith is a badass and doesn’t need a man, so the show is just fine (and sometimes better!) without its most iconic couple. But that doesn’t mean we weren’t blessed to watch them fall in love for 11 seasons. Callie puts it best when she tells a doubting Meredith that Meredith and Derek are “living proof that love exists.” That Meredith and Derek are “a frickin’ romance novel.” What’s the most romantic part of their story? The “Pick me. Choose me. Love me” of it all? When Meredith makes an outline of the dream house using candles? The elevator proposal? The Post-it note wedding? The fact that Derek finds Meredith on her Death Beach and tells her he loves but that she needs to go back to their children? Admittedly, that last thing became grating by the end, but still, Meredith and Derek transcend space and time!

We watched them survive more hardships than most: failed trials, Addisons, almost-drownings, miscarriages, Derek’s beard phase, shootings, the president taking up all of Derek’s time, etc. Thankfully, before Derek tragically meets his end, the two are in a very good place. They’ve been fighting for almost an entire season until finally Derek realizes that what’s most important is Meredith. He stops their fighting by “calling Post-it. And Zola. And Bailey. And tumors on the walls. And ferry boat scrub caps.” Now, if you’re not already swooning, check your pulse. He tells his wife that he can’t live without her, and more importantly he doesn’t want to. Before Derek dies, he realizes what the audience already knows: The most important day of his life (and ours) was the day he met a girl in a bar.

Every Couple on Grey’s Anatomy, Ranked