Throughout the past two decades, researchers have studied the close relationships of patients to understand the role that these relationships play in the maintenance and alleviation of pain and the role that pain plays in affecting relationships. In this article, a brief review of the evidence is provided, showing a link between marital functioning and pain, and the marital problems reported by patients with chronic pain in our studies also are described. We provide information about several promising couples pain management and couples therapy approaches that appear to help couples manage pain together. Recommendations for clinical and research directions also are offered.