The Best And Worst Couples On Grey's Anatomy

Few shows have the heart-wrenching capabilities that Grey's Anatomy does. Over its 17 seasons, creator Shonda Rhimes gave viewers some of the best and worst on-screen romances, as well as relationships that exist somewhere in the middle. And, as avid fans will tell you, each relationship served a purpose. Maybe the characters involved were looking for comfort in the wrong places, or bonding over their love of surgery. Others had intense physical chemistry, and some were just plain soulmates.

Grey's Anatomy has a tendency to keep viewers on their toes when it comes to its romances. Many didn't go the way viewers had hoped, as some ended in tragic deaths, and others perished in divorce. And really, no matter the storyline, the couples in the Grey's world have all gone through a lot, which of course made great TV for us.

Ultimately, it's safe to say that some Grey's Anatomy couples were a lot healthier and more meant to be than others. So here are the best and worst couples on Grey's Anatomy (warning: spoilers ahead.)

Best: Starting off strong with everyone's favorite Grey's Anatomy couple, Meredith and Derek

The couple that really held down Grey's Anatomy was Meredith and Derek. Fans rejoiced when these two finally got together, and subsequently balked when Derek passed away in Grey's Anatomy's most controversial episode ever. The two surgeons created such a beautiful life together that it made their on-screen romance feel that much more real, rendering them one of the best couples on the series. 

Fans were treated to a chorus of emotions when Derek appeared in the season 17 premiere, as the couple were reunited in a dream sequence. Ellen Pompeo and Patrick Dempsey spoke to Deadline about their on-screen reunion, and why bringing back Mer-Der was worth it. "There's just so much darkness, and we knew that coming together would be a little ray of light," Pompeo said. "Patrick and I have this chemistry, where I think, even from when we first just felt like we've known each other for a hundred years." 

Dempsey echoed the sentiment, saying that coming back was "very special." Here's to hoping that the Grey's writing team finds a way to bring these two back together for real.

Worst: Callie and George were truly never meant to be on Grey's Anatomy

The best thing about Callie and George's romance on Grey's Anatomy was the fact that for a time, Callie was Callie O'Malley — if you had that name, you wouldn't stop saying it. But their marriage was doomed from the start. Not only did the couple completely rush into their marriage, but their on-again, off-again dynamic was not at all sustainable. 

Things really took a turn for the worse when George cheated on Callie with Izzie — a fellow intern and George's best friend — and everything was pretty much downhill from there. At one point, Izzie even thought that Callie wanted to physically fight her over George!

George and Callie were one of the worst couples on Grey's Anatomy for a number of reasons, but as fans will tell you, one of the main motivations for their marriage needing to end was because Callie deserved so much better. She was smart, ambitious, caring, and tried so hard to make her marriage work, and George still cheated on her. Cue Rachel's line from Friends: "Once a cheater, always a cheater."

Best: Cristina and Owen had a difficult relationship, but Grey's Anatomy fans still loved them

Who knew that an icicle could cause so much sexual tension? Well, Grey's Anatomy fans now know that if an icicle lands in your stomach, you should only be treated by a certain gorgeous trauma surgeon. 

That's exactly how Cristina and Owen met, and thus began their rocky relationship. The two were on-again, off-again, and then on-again, and even got married despite everything they'd been through. Let's name a few: Owen tried to choke Cristina to death in their bed during a traumatic episode (don't forget, he'd been an army surgeon.) They also fought constantly about having children, and even after their divorce, continued sleeping together. 

For all of Cristina and Owen's problems, they were still one of the best couples; fans know they truly cared for one another. But in the end, Cristina ultimately chose her career over the life of marriage and babies that Owen so desperately wanted, in one of Grey's Anatomy's most devastating breakups. She eventually moved away from Seattle — leaving Owen there to figure out his life. But we sure did love them together.

Worst: Owen and Amelia were messy from the start on Grey's Anatomy

Owen from Grey's Anatomy clearly has a thing for dysfunctional relationships, because after his divorce from Cristina, he once again fell into the arms of surgeon: Amelia. Their time as a couple was so messy that Bustle actually put together a timeline of their drama. Notably, Owen had a significant amount of trauma from his time in the army, and Amelia struggled with her addiction. 

After Derek died, Amelia leaned on Owen, and about half a season later, the two quickly got married. It seemed natural for the two to rely on each other, but given that they were just as messed-up as the other, things inevitably went downhill. Not dissimilar to Owen's problems with Cristina, the couple disagreed on children. And, as if things couldn't get any worse, in season 14 Amelia found out she had a brain tumor. 

Luckily, the tumor was successfully removed, but by that point, Amelia and Owen had gone through so much as a couple that they were beyond repair. Their ensuing breakup was one of Grey's Anatomy's most heartbreaking moments.

Best: The most devastating and yet beautiful couple on Grey's Anatomy was Mark and Lexie

If there's one couple from the Grey's Anatomy world that deserved the world, it was Mark and Lexie. These two were soulmates, and despite their rocky relationship, they were destined to be together. But like many of the best couples in Grey's, Mark and Lexie broke up when things got complicated. 

Specifically, Mark's daughter came to town, prompting Mark to step up as a father, but leaving Lexie without the relationship she wanted. Then, after their break up, they both dated other people. And when Mark got together with Julia, it seemed like their relationship was doomed. Then the plane crash happened. 

For those of you who are binging Grey's Anatomy, stop reading here. After the plane crash, Lexie succumbed to her injuries and died as Mark was telling her about the life that they were supposed to have together. Then after a battle with his injuries sustained from the crash, Mark died too — almost solidifying that they indeed did belong together, both in life and in death. But reliving their relationship still hurts the heart on a lot of levels.

Worst: Alex's relationship with Rebecca/Ava on Grey's Anatomy was doomed from the start

Relationships between the doctors and patients on Grey's Anatomy don't happen too often, but when they do, they've been painful. Notably, Alex and Rebecca/Ava, the pregnant patient he rescued from a tragic ferry boat accident, were one of the worst couples on Grey's Anatomy because one, Alex couldn't take care of her injuries, and two, their relationship was so twisted and unhealthy. 

As noted by PopSugar, Alex tried to take care of Rebecca/Ava, and even let her come and stay in the house he lived in with Meredith and Izzie. But after a psychotic break, Alex was finally convinced that he couldn't give her the care she needed. 

It's later revealed that Rebecca/Ava had borderline personality disorder, and the relationship arguably became a parallel for what Alex went through as a young man with his family. (It's shown through conversations and admissions on Alex's part that he cared for his mother in a similar way to that of Rebecca/Ava.) We're just really glad that Alex was able to move on from this one.

Best: When their relationship was good, Jackson and April were truly the best on Grey's Anatomy

We love a risk-it-all move for love, and April and Jackson were the epitome of throwing caution to the wind on Grey's Anatomy. After an on-again, off-again relationship with Jackson, April had gotten engaged to a sweet golden retriever of a man, Matthew. As noted by ABC, April and Matthew were all set for their big day, but when they were standing at the altar, Jackson got up and professed his love for April. She clearly had unresolved feelings for him, because she left her fiancé and ran off with Jackson into the sunset. 

For a while, April and Jackson's relationship seemed hopeful, but things ultimately got complicated. The pair received a devastating blow when they found out that their unborn baby had a terminal disease, and April eventually gave birth only to have their baby die in her arms. 

April and Jackson eventually got divorced — even though April was once again pregnant. And while they didn't make it in the end, April and Jackson made it on the best list because when it was good between them, it was so good.

Worst: Callie and Penny just had the worst timing on Grey's Anatomy

This Grey's Anatomy relationship got awkward really quickly. After Meredith decides to host a dinner party, Callie brings her new girlfriend, Penny, as her date. But before the evening really begins, Meredith quickly recognizes Penny as the doctor who (unintentionally) killed her husband Derek after his car accident (via Closer Weekly). So yes, things got super awkward after that.

But the relationship between Callie and Penny was also unhealthy for a number of reasons. It culminated when Callie went to great lengths to reorganize her life in order to follow Penny to New York City (where she'd been awarded a research grant.) As noted by ABC, Callie and her former partner, Arizona, went through a brutal court battle over child custody after being unable to reach an agreement. 

Despite Callie being her daughter's biological mom, Arizona won full custody of her, really delivering a blow to Callie and the life she had known up to that point. And considering that things got off on an awkward footing with Penny, the couple has easily made it onto the worst list.

Best: True Grey's Anatomy fans know that Alex and Izzie were meant to be

Alex and Izzie: the pair went from enemies to friends to husband and wife on Grey's Anatomy, and took viewers on an emotional roller coaster. As noted by Elite Daily, Izzie and Alex kept "finding their way back to one another at different points of their medical journeys." Despite all the hardships they went through, they always relied on each other, making them one of the best couples on the show. 

But when Izzie was diagnosed with cancer, their relationship took on a whole new meaning. To distract herself, Izzie threw herself into planning Meredith and Derek's wedding. But when the big day came, Izzie replaced Meredith as the bride, Alex replaced Derek as the groom, and the two tied the knot. The wedding was beautiful, and any Grey's fan who says they didn't cry while watching it is lying. 

Izzie and Alex's relationship eventually ended when Katherine Heigl left Grey's Anatomy after season 6. But when Alex finally departed in season 16, fans learn he'd rejoined Izzie and his children. Needless to say, these two were destined to be together.

Worst: Poor Callie and her toxic back-and-forth with Arizona was painful to watch on Grey's Anatomy

Callie deserves better than the relationships that she's endured on Grey's Anatomy, and her tumultuous relationship with Arizona was no exception. Arizona was the first woman that Callie got serious with, and they went through many hardships while navigating their romance. 

According to ABC, Callie and Arizona went through it; they finally seemed to figure out their relationship, when Arizona abruptly left for a medical trip to Africa. Things escalated further after the two sustained serious injuries as a result of the tragic plane crash that took Lexie and Mark's lives — Arizona eventually had to have her leg amputated. From that moment on, Callie and Arizona consistently fought. Arizona even ended up having an affair with another doctor. It became one of the worst relationships on Grey's Anatomy, especially given everything that they'd been through. 

Things started to look up when the Callie and Arizona tried to put their differences aside. They bought a house together, tried to have a second baby, and started going to therapy. But their efforts fell short and they eventually got divorced.

Best: Bailey and Ben are Grey's Anatomy's heart and we love them together

The best relationships on Grey's Anatomy tend to start in tense circumstances, and that was certainly the case for Bailey and Ben. While Bailey was operating and Ben was serving as the anesthesiologist, the patient weirdly woke up on the table. As noted by Bustle, Bailey fully chewed Ben out for what she thought was his mistake. However, the patient turned out to have a strange condition that impacted her sensitivity to anesthesia. 

After that, Bailey and Ben fell in love, and despite all the hardships they endured — like the aftermath of the hospital shooting and Ben's suspension after the hallway C-section — their relationship remained intact. 

Season 17 brought some of Grey's Anatomy's heart-wrenching realities to the couple, given that the season arc largely has to do with the COVID-19 pandemic. As noted by CheatSheet, Bailey greeted her husband while wearing full PPE, and Ben (along with the firefighters from spin-off show Station 19) gave a "clap off" to all of the first responders and staff of the hospital. It's safe to say that these two are one of Grey's Anatomy's best couples.

Worst: Richard and Ellis's relationship had significant fallout

Things were already complicated before Grey's Anatomy began. Richard, the hospital's chief surgeon, had been romantically involved with Meredith's mom, Ellis, while they were medical residents. Because of their affair and the tension that came with it, Meredith often found herself trapped in awkward situations with Richard — and as the truth about their affair came out, things only got messier. 

Richard and Ellis dated, even though both of them were married to other people. Things got increasingly complicated when Ellis found out she was pregnant with Richard's baby — she tried to end her life as a result. Viewers eventually came to find out that Meredith's fellow surgeon, Maggie, was the daughter of Richard and Ellis who had been put up for adoption. 

Later in her life, Ellis was diagnosed with Alzheimers and eventually passed away, but the schism left from her relationship with Richard was felt in the many seasons after her death, in part due to the toxic nature of their romance.

If you or anyone you know is having suicidal thoughts, please call the National Suicide Prevention Lifeline​ at​ 1-800-273-TALK (8255)​.

Best: Izzie and Denny's love story on Grey's Anatomy still hurts our hearts in the best way possible

If there's one couple from Grey's Anatomy that still pulls on our heartstrings, it's Izzie and Denny. Denny was a heart transplant patient at Seattle Grace, and Izzie started caring for him as a doctor. But things quickly evolved when the two became romantically connected, leading Izzie to make one of the worst medical decisions of her career. 

According to the Los Angeles Times, Izzie cut the lines to Denny's heart device in order to move him to the top of the transplant list; she believed that a heart had become available. Denny is eventually given a heart that was supposed to be for another patient, but even after the transplant, he dies shortly after surgery. 

Although their romance and time together was short, Denny and Izzie made a huge impact on those around them. It's later revealed that Denny left millions of dollars to Izzie, who eventually gives the money to the hospital to set up its free clinic. All in all, Denny and Izzie's romance was brutal and tragic, but they still remain one of Grey's best couples.

Worst: This might be controversial, but Burke and Cristina were not meant for each other on Grey's Anatomy

One of the earliest established couples on Grey's Anatomy was Cristina and Burke, and from the start they seemed to be a good fit. They were just as dedicated to their careers as surgeons as they were each other, and their emotionless affects seemed to compliment each other. But as their relationship evolved and Burke eventually proposed, viewers started to see the ways in which Cristina was pressured to change. 

As noted by Bustle, Burke's expectations that Cristina would be the welcoming bride couldn't have been further from who she was. As Meredith said, Burke "cut away pieces" of Cristina while they were a couple, and at the end of their road, Cristina seemed like such a different person. And of course, the nail in the coffin was when Burke literally left her on their wedding day. She was in the dress, had done the makeup, and was willing to walk down the aisle, and Burke just up and left. 

Burke and Cristina eventually reconciled seasons later as colleagues, but these two were never meant to be a couple.