Grey's Anatomy Couples: The Definitive List and Ranking

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Medicine comes second only to romance at Grey/Sloan Memorial. Did your faves make the top 5 Grey's Anatomy Couples

Grey's Anatomy Couples.. where to even begin? There have been SO many over the years. While all of the Grey's Anatomy couples are great in their own way, not all Grey's Anatomy couples are created equal. This list is the definitive ranking of the Grey's Anatomy Couples as voted on by our community.

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27) Bailey and Tucker

Despite bringing a cute af baby into the world, it always seemed like Tucker begrudged having to be a stay-at-home dad, and didn't understand the demands of Bailey's career. Bailey needed someone who would support her in her dreams to be both a successful surgeon and a mother, and it wasn't Tucker Jones.

26) George and Nurse Olivia

Ahhhh George and the Spyh Nurse. Admittedly, Alex Karev was the cause of the Syphilis outbreak, but this pairing was never going to work out based on the fact that Olivia was TOTALLY George's rebound girl.

25) George and Callie

Yeah, this is quite a low ranking for a pairing between two of our main surgeons, but tbh we were totally with Izzie in hating this couple. Callie grew on us as the seasons went on, but here she was the symbol of George's grief over his dad, manifesting itself in the form of a Vegas wedding. Not good. Plus Callie hated George's friends at this point, which we could never get on board with.

24) Alex and Rebecca/Ava

This was just tragic and painful to watch. As much a Rebecca did some slightly questionable things, we have to remember that she was suffering from a mental illness as a result of her trauma; she needed help, and Alex was about to do anything to support her. The problem was that in this case, he was more of a caregiver than he was a boyfriend.

23) Cristina and Shane

Shane was like a dog with a bone, doing everything he could to please Cristina in the bedroom. Sure a girl has needs, but there's a lot more to a relationship than just sex, and with a girl as complex as Cristina, Shane would have to had offered a lot more to move up this ranking.

22) Izzie and George

Ah yes. We thought this pair was going to be perfect, especially following the George and Callie debacle, and yet this pairing just did not work. Here's to George and Izzie as best friends rather than lovers.

21) Stephanie and Jackson

This relationship was a little dull; there never seemed to be that much chemistry between these two (probably because Avery was still holding a candle for April). Despite this, Edwards definitely deserved more than being broken up with in front of all her colleagues and friends. That was poor form on Jackson's part, no matter how intense his love for April.

20) Lexie and Jackson

We almost forgot about this one! Like all of the relationships on Grey's it seems that they had no problems getting it on (all over the hospital for that matter), but Lexie still loved Mark, and Jackson still loved April, so this was more of a stop-gap relationship than true love. At least there were no public humiliations with this break up.

19) April and Matthew

This was such a sweet pairing, with April finally finding someone who shared her religious convictions. This was a textbook romance, with a flashmob proposal and all the sweetness you could want. However it was clear when we saw April's reaction to believing that Jackson had died during the super storm that Kepner's heart belonged to someone else.

18) Webber and Ellis Grey

Although it was clear that Ellis and Richard loved each other, and were what each other needed during their intern years, we have to remember that this relationship broke up a marriage and very nearly tore up another. Plus we got all sorts of drama with secret half siblings and daddy issues which really made life complicated for Meredith, Lexie and Maggie.

17) Callie and Penny

Yeah we're not huge fans either, but when it comes down to it, Penny makes Callie happy and that's something that she hadn't experienced in her marriage to Arizona for a long time. Though we haven't seen much of this couple, we're sure they're killing it in NYC.

16) Owen and Amelia

This is admittedly a low raking for a still established couple (as far as we know), but this whole relationship is a little off. It's been built from awkward encounters, with the proposal coming off the back of a hypothetical discussion about the future (not exactly the most well thought out plan), and both Owen and Amelia seem to need each other more as an emotional crutch than as a life companion. Maybe things will pick up, but right now these two just don't seem compatible.

15) Mer and McVet

Perhaps a high ranking for this short-lived couple, but we had a soft spot for Finn and the lengths he was prepared to go to to win over Meredith. Her certainly gave Derek a run for his money in the dating game, and he supported Mer whilst Derek was trying to have his cake and eat it too. What can we say, we liked them!

14) Webber and Catherine Avery

Again, this is a little low for a still existing couple, but compared to Richard's other relationships this one seems to be a little flat. Plus Catherine just brought in a woman to replace her husband as the leader of the intern program, so there's that.

13) Bailey and Ben

Probably the only guy just as headstrong as Miranda, Bailey needed someone who understood the demands of her job, and a fellow surgeon is probably one of the only other people who can. Sure they've had their ups and downs (you know the whole emergency c-section, church and state thing) but they've come through and seem to be perfect partners right now!

12) Derek and Addison

These two perhaps didn't make the best married couple, given the fact that they both had affairs of one kind or another, but they showed us how a couple can split and still be amicable, supportive and remember all the good things about one another. Plus they had that cheesy cheesy song that Derek wrote, so that's something.

11) Webber and Adele

Patience of a saint award goes to Adele, who stuck by Richard through his long hours, through his affair, and through his alcoholism. Though it took Richard a while to figure out how to balance his career with his relationship, when it came down to it, the love he had for Adele was clear and we definitely teared up when Adele's Alzheimers progressed and she forgot who Webber was.

10) Izzie and Denny


This was our first glimpse into the tragedy that comes with a Grey's Anatomy addiction. Despite being medically dubious, we loved the cheeky sass that Denny brought to Seattle Grace. Denny's death was a classic heartbreaking moment, but it also gave Izzie the chance to become an incredible surgeon, and teach Alex how to be less of an ass.

9) Callie and Arizona

Ugh we *loved * these two, until we didn't. Callie and Arizona brought out so much good in one another, had a beautiful daughter and taught us a lot about love, tolerance and friendship. Then that whole leg amputation thing happened and things were never the same... they don't call it irreparable damage for nothing. We wish this couple could have made it work, but some divides are just too large to patch over.

8) Cristina and Burke

Some people love this couple, others not so much. Us, we sit somewhere in the middle. Burke taught Cristina how to be both human and a surgeon, developing her compassion and honing her surgical skills, but when it came down to it, he was also trying to mould her into a different person. It's just a shame it took him until their wedding to realize that whilst Cristina would do anything to be the woman he wanted, she would also have to lose part of herself to do so.

7) Izzie and Alex

We ranked this couple so high because of the growth that happened during this relationship. It was in his relationship to Izzie that Alex really started to change from Grade A ass to a guy with depth, who could really care for a person other than himself. That and there was a time where Izzie chose Alex over Denny, which is saying something. We just wish Izzie hadn't left because if someone didn't need another reason not to trust in relationships, it's Alex Karev.

6) Cristina and Owen

These two showed us what it's like to support each other through the darkest times. With both Cristina and Owen separately suffering from PTSD at various points, they helped support one another, and Owen was the one able to bring Cristina out of her psychosis following the plane crash. Unfortunately the whole kid thing was what ultimately drove this couple apart, and though we can't fault Cristina for her conviction and knowing that a baby just wan't what she wanted, we're still kinda bummed about it.

5) Alex and Jo

If his relationship with Izzie was a glimpse into Alex's potential, his relationship with Jo is where Alex came into his own. These two built a connection around their difficult histories, unafraid to bare all (the dark twisty bits and all). We wish Alex wasn't such a hot head, because his anger is seriously making problems, but here's hoping Karev can put that behind him and now that the secret hubby is out of the bag, that Jo and Alex can foster the future that they both deserve.

4) Teddy and Henry

We're throwing it back for this one! In the rankings of tragic Grey's deaths, Henry's is up there. Despite having its beginnings as a green card marriage, Teddy and Henry developed a real relationship, and they were excited to build a future together in spite of Henry's medical complications. Seeing Teddy's grief following Henry's untimely death showed us the scar that losing the love of your life can leave, and helped cement this couple in at number 4.

3) Jackson and April

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These two had the rockiest of starts, and also far from the smoothest of middles. These two grew from fellow interns, to lovers that eloped, to parents that lost a child, to near divorcees, to second time parents, and back to lovers. Whilst Jackson and April are just beginning their voyage back to happy couple status, their struggles have taught them how to make room for one another's beliefs so that they compliment rather than confront each other. We're excited to see where these two go!

2) Derek and Meredith

The OG couple, MerDer, Mc Dreamy and the Slutty Mistress. We watched these two overcome every hurdle thrown at them, loved them through their PostIt note marriage and tumor on the bedroom wall, and seen them become a power couple living in the dream house with a cute lil family unit. Of course Shonda had to crush our dreams and kill off Derek (which we will never get over), and Mer is now trying to navigate life as a widower. For now, it seems like there could be a budding romance between Mer and Riggs, but Meredith and Derek are always gonna be #couplegoals.

1) Mark and Lexie

The number one spot goes to McSteamy and Little Grey. These two were the ying to each other's yang; Lexie taught Mark how to be monogamous (who saw that coming?) and be the perfect boyfriend, whilst Mark taught Lexie how to let go, and live a little. With them, we imagined how they would get married and have kids (a sister and two brothers for Sofia), becoming a beautiful family. As Mark said to Lexie as she lay dying, they were "meant to be". And then we started crying for what felt like eternity. This number one couple clearly shone the way for the surgeons at Seattle Grace too, with their love and medical skills immortalized in the name change to Grey Sloan Memorial hospital.

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