Twenty years is a long time — for a relationship or a TV series like Grey’s Anatomy. Just when you think there’s nothing more to do, surprise!
Fans continue to tune into Grey’s every season for the latest medical cases, relationship drama, and robust storytelling.
We don’t get as much Meredith these days, but there is still enough to satisfy viewers, including the relationship mishaps with her new love interest.
While the show doesn’t have the same pizzazz and character compatibility as it did in the early years, there is plenty of relationship messiness to entice fans.
But no matter how great — or bad — things get at GSM, some relationships have happened in the last 20 years that fans will never forget. And some never got the ending they deserve.
Here is a list of our favorite on-screen Grey’s Anatomy ‘ships of all time.
Meredith Grey and Derek Shepherd
The chemistry between Meredith Grey and Derek Shepherd hooked viewers from the first glimpse and still captivates two decades later.
A love like theirs never dies, even when one (Derek) does. Their relationship went through the worst of ups and downs, like meeting Derek’s wife (ex).
No other couple has captured that air of everlasting love, of being there for each other no matter what.
Derek may not be with Meredith in person anymore, but we can still feel their love years after Derek’s soul left this mortal plane.
Meredith Grey and Nick Marsh
Fans loved the union between Nick and Meredith from the start. Meredith was finally opening her heart again years after Derek’s death.
What started as long-distance became a serious ‘ship when Nick joined the staff at Grey Sloan. While Meredith left GSM for a job in Minnesota.
In Season 20, fans adore seeing Nick playing the attentive parent to the kids back in Minnesota while Mer is back in Seattle at GSM.
Seriously, can they ever be in the same place simultaneously?
Derek Shepherd and Addison Montgomery Shepherd
We can’t mention Derek’s former relationship without including them on this list. Because the two doctors made an incredible pairing in the beginning.
Before Addison had an affair with Derek’s best friend Mark. It’s her infidelity that pushed Derek to Grey Sloan (Seattle Grace Hospital) and into the arms of Meredith.
While Derek and Addison were still married at the time, it was in name only.
Viewers had a split reaction on whether Derek should have worked harder to keep his marriage with Addison going or end the ‘ship to focus on what was developing between him and Meredith.
Once a cheater and all that. The Mer-team won as Derek finally chose a path.
Addison Montgomery and Mark Sloan
We fell in love with the sexy womanizer Mark Sloan from our first meeting, despite being a scoundrel for his affair with Addison.
We had less positive feelings for Addison, the cheating wife.
Despite their relationship starting through infidelity, we immediately rooted for them.
If Addie was with Mark, Derek was free to pursue Meredith.
It didn’t take long to learn that Mark wasn’t just Dr. McSteamy, a sexy face and hard-toned body. He was also a brilliant, talented doctor and a nice guy with strong relationship possibilities.
We almost felt sorry for his love-sick feelings. He gave up his life in the city to follow Addi to Seattle.
Despite his sacrifices, their relationship withered into nothingness. However, everyone stayed good friends, so there was light at the end of the tunnel.
Mark Sloan and Callie Torres
Mark’s personality made him a perfect candidate to be friends with females like Addison and Callie Torres.
He and Callie started off as a random hookup.
And they continued to have a sexual arrangement without the messy emotions of a relationship. Many fans hoped they would become more.
Alas, friendship is all that was there, despite having a daughter together in later seasons. Their friendship helped Callie realize her bisexuality, getting her on track to meet the two great loves of her life — both females.
Mark Sloan and Lexie Grey
Poor Mark went through the wringer in terms of relationships. It seemed like he couldn’t catch a break on finding the right woman.
First Addison, then Callie.
Things seemed to change when he met the sweet and young Lexie Grey. Sparks flew, as did the tensions and warnings. Their union was forbidden, which made it all the more exciting.
We saw a different side to Mark, but his desire for a secret relationship wasn’t fair to Lexi, even if it was for good reasons — like keeping his best friend from finding out he was sleeping with his sister-in-law.
While the passion was there, the foundation wasn’t. Mark wanted kids. Lexie didn’t.
Despite splitting up, they stayed in love right up until their deaths after the plane crash in Season 8 Episode 24.
Callie Torres and George O’Malley
George was a nerdy doctor, so no one was more shocked than him when the hot Callie showed interest. But interested she was, as were we.
But while Callie seemed to be all in, George was more reluctant to commit. He proposed on a whim, and they got married in Vegas.
But the marriage was a short one. Callie left George after finding out about his one-night stand and true feelings for Izzie.
His death hit Callie hard, resulting in her going back to Sloan, paving the way for her to have Mark’s kid and discover her dual sexuality.
George O’Malley and Izzie Stevens
The relationship between George and Izzie Stevens lasted longer in nuance than it did in reality. They had a strong, supportive love, but it was more of a best friend who was always there for you.
First, George was in love with Izzie but kept quiet. Then when he was married, Izzie decided she loved him too.
After a one-night stand, their relationship tried to take off. Most of us fans weren’t here for it.
Thankfully, it faltered at the starting line. They unanimously agreed it wasn’t the right time. Unfortunately, they never saw what could have been before George died heroically.
Izzie Stevens and Denny Duquette
Despite the rule against doctors dating their patients, Izzie Stevens fell for Denny Duquette, a patient in need of a heart transplant.
When it looked like Denny would die before getting a new organ, Izzie broke the law and her oath to push him up the transplant list.
Although he got a new heart and proposed to Izzie, he died of a stroke shortly after she accepted.
His death continued to affect Izzie through future ‘ships. His ghost diagnosed her brain tumor.
Callie Torres and Arizona Robbins
The relationship between Callie and Arizona was one of conflict and drama and lots of on-again, off-again.
As Arizona courted Callie, she simultaneously seduced the audience.
The couple went through the ringer, experiencing job changes, a disagreement on kids, and a plane crash that killed several GSM doctors.
Fans knew we were witnessing a love that could outlast anything. Except we were wrong.
The couple had several major fights that eventually led to a nasty custody battle over Sophia, the daughter Callie shared with Mark.
Most fans hated the way their love story ended so brutally cruel. Callie left Grey Sloan to be with her new girlfriend, Penny, in New York. Arizona followed later to be close to her daughter.
Fans learned they reunited off-screen a few years later. Arizona’s appearance on Grey’s Anatomy Season 20 Episode 4 left fans disappointed that we didn’t learn where the couple stands.
Callie Torez and Penny Blake
We weren’t sure what to make of Penny Blake when she joined Grey’s. And once she became the doctor that killed Derek, we had our minds made up.
So, fans had mixed feelings once she and Callie got serious. While we wanted our girl to be happy, we weren’t sure it should be with Blake. The relationship didn’t stay on screen as long as others but it had major impact.
When Blake got a job across the country, Callie followed. Unfortunately, not before fans went through a lot of drama, like the custody battle.
Grey’s fans ended up saying goodbye to another of their favorite doctors. Later, it’s mentioned that the couple broke up a few years after the move.
Alex Karev and Lexie Grey
Meredith isn’t the only Grey with relationship problems. Lexie also had quite a time finding true love.
Like several other Grey Sloan staff, she had a brief fling with fellow doctor Alex Karev. Fans saw the writing on the wall from the start.
Poor Lexi would be doomed for heartache if she fell for Alex, since he was in love with someone else. (See a trend?)
Thankfully, she never fully invested in the relationship and wasn’t devastated when it fizzled out.
Alex Karev and Izzie Stevens
Izzie and Alex were friends before they became lovers. Given their horrible track record for relationships — like falling for their patients — fans had mixed feelings when the two started having chemistry.
Alone, both doctors were a mess. But they brought out the best in each other.
The romance allowed the playboy Alex to redeem himself as he proposed to Izzie despite thinking she was going to die from cancer.
Instead of the wedding for Meredith and Derek, we watched Alex and Izzie join in holy matrimony.
Although Izzie survived her diagnosis, their marriage did not. Fans had mixed feelings about Alex’s decision to end things after Izzie left but returned for a second chance.
Alex Karev and Jo Wilson
Izzie had been good for Alex in many ways, including helping him mature into a great doctor.
So when sparks flew between him and Jo Wilson, fans knew he was finally ready for a serious relationship.
Alex and Jo were two peas in a pod despite all the drama in their relationship stemming from the past. When they finally overcame their hurdles, we were sure to see a happily ever after.
Things were perfect until they weren’t. Without warning, Alex left one day to visit his mom. Or so we thought.
Then suddenly, he’s AWOL, no phone calls, no correspondence. Complete ghosting.
Turned out he found his baby mamma, Izzie, and chose to stay with her over his current wife. Delivering the news and divorce papers in the mail? Harsh move, Doc!
Jo Wilson and Atticus Lincoln
After two failed marriages, Jo was hesitant to be with anyone else, especially after adopting daughter Luna.
But who could resist falling for sexy surgeon Link.
Link and Jo’s relationship goes back to their pre-doctor days, when they worked together as food servers.
At first, they were just really close friends, but fans saw the chemistry.
The friends became lovers after Link’s failed relationship with Amelia gave him a son. While raising their kids as single parents, feelings grew into a romantic love.
Season 20 has the two in couple mode, and things seem to be going well so far into the shortened season.
Jackson Avery and April Kepner
Jackson came onto the scene as the boss’s son and April as the devout Christian.
After Jackson took April’s virginity, most fans expected them to stay together.
But after so much pointless back and forth, fans got over the redundancy and started to hope for something else.
We saw a lot of repeated storylines — April almost married the wrong guy, she left the country, she came back ready to pick up where they left off.
Despite marriage and shared kids, Jackson was unwilling to put in the work, and their union fizzled out.
The couple divorced but later rekindled their ‘ship off-screen when April and their daughter followed Jackson to Boston.
Jackson Avery and Lexie Grey
Grey’s Anatomy has been a revolving door of shared partners. Fans have seen plenty of meant-to-be hookups and just as many WTF are you thinking ‘ships.
After Jackson and April split up and Lexie dumped Mark, things started to heat up for the two newly single doctors.
The connection between Lexie and Jackson was primal and purely physical, as both people were still in love with their “one.”
It was clear from the beginning that they were using each other as an escape.
So it didn’t surprise anyone when Jackson dumped Lexie due to still being in love with Mark.
Cristina Yang and Preston Burke
Cristina was everyone’s favorite brilliant, egotistical surgeon, and Burke was the perfect mentor. Their coupling split fans.
The relationship seemed inappropriate for many because Burke was Cristina’s boss.
Although there were challenges, such as the difference in job title and religious beliefs, the couple stayed together until their wedding day.
On what was to be the best day of their lives, Cristina experienced the worst when Preston left her on their wedding day.
Cristina Yang and Owen Hunt
Owen Hunt came to Grey Sloan in a flurry of action and doctor brilliance.
It’s no wonder his unique manner of medical treatment caught the eye of Yang.
Their courtship was messy and seemed like it would end several times, but they ended up married instead.
Although there was plenty that should have kept them apart.
Several factors worked, like nails in a coffin, to finally end their marriage. They originally divorced for the lawsuit after the plane crash.
But Cristina left to take a job in Switzerland and fully ended their relationship when she realized Owen wanted kids. She didn’t.
Amelia Shepherd and Owen Hunt
From our first introduction, Amelia was a mess. Although Derek’s sister, fans did not see much family resemblance.
Both doctors had a rough past, with plenty of demons still haunting them. Hunt had PTSD from his time at war.
Amelia was a drug addict with a brain tumor that caused irrational behavior.
Misery loves company, so no one felt surprised when the couple tied the knot. Just as the marriage began, the couple argued about having kids, which led to an amicable divorce.
Fans watched in horror as they decided to try their relationship again after the brain tumor was gone.
But before we had to get on board with round 2, they experienced a final blowout that led to the end of their coupling.
Amelia Shepherd and Atticus Link
After the failed ‘ship between Amelia and Owen, there was the possibility of Amelia with Link.
Fans were in love with the pretty boy surgeon who gave Amelia all the attention and understanding she didn’t get with Owen.
He even pretended to be her former husband during a family dinner, so Amelia wouldn’t have to admit to her divorce.
He went to bat for her and fans weren’t the only ones to appreciate his support.
The couple started as friends, grew into lovers, had a child together, and split up. But despite their division, the couple are excellent at co-parenting.
Owen Hunt and Teddy Altman
Teddy and Owen go back pre-hospital to when they worked together overseas as Army surgeons.
Despite having feelings for each other in the desert, they start with a platonic relationship once Teddy comes to Seattle Grace.
The couple finally got their chance together after Owen went through several failed relationships, including with Cristina and Amelia.
Things were rocky from day 1 as Teddy struggled to be the backup. It wasn’t until she got pregnant that she was ready to try with Owen.
Who was still with Amelia.
After the birth of their daughter, Owen finally proposed to Teddy, who was in another relationship at the same time.
The couple are still married — although there’s often drama — in Season 20.
Miranda Bailey and Ben Warren
Miranda’s big personality and brilliance made everyone fall in love with her, including then-anesthesiologist Ben Warren — now a firefighter at Station 19.
After Bailey’s disaster of a marriage to her first husband Tuck, fans swooned over the intense wooing Ben did to capture her attention.
Everything about the man seemed perfect, which only seemed to work against him as Bailey resisted his advances.
Fans are thrilled to see that her disinterest didn’t last long.
Their love story is the epitome of what we think a perfect marriage should be, even years later when most other relationships have fallen to the wayside.
Richard Webber and Catherine Fox
The early seasons of Grey’s Anatomy revealed the history between Richard and Meredith’s mother, successfully laying the foundation for the entire series.
After the emotional ordeal of Richard’s first marriage, fans were glad to see him get a second chance at love.
No one expected more heartache in the works as his new love, Catherine, got sick too.
The man seriously can’t catch a break! It’s no wonder he struggles with alcohol.
As of Season 20, fans are glad to see the marriage still going strong and hold out hope that Catherine’s current health prognosis continues to stay positive.
Levi Schmitt and Nico Kim
Levi made quite the impression as a surgical resident. Since his nerdy fumbling as a first year, he’s become quite the doctor. Even if his love life hasn’t worked out as well.
Fans cheered in delight when Levi finally found someone to help him explore his sexuality. Nico was the perfect first, but fans never expected it to be Levi’s only.
Unfortunately, their relationship didn’t last, but no one ever forgets their first. Especially when it’s as life-changing as realizing you’re gay.
Many fans hoped that Nico would return and the couple could start again.
No one expected to see Nico re-appear in Season 20 Episode 3, happily married and with a baby on the way.
It broke poor Levi’s heart, but fans hope it was the closure he needed to finally move on and find his true love.
Maggie Pierce and Winston Ndugu
Maggie’s arrival at GSM caused quite a stir since Meredith was unaware she had another sister.
And Richard was just as shocked to find out he had a daughter.
Maggie had a few relationships before Winston, including Andrew DeLucas and a brief dalliance with Jackson Avery (whose mom was married to her dad).
At the beginning of their relationship, Maggie and Winston lived long distance. She lived in Seattle, and he was in Boston.
After COVID, Winston relocated to Seattle to work at Grey Sloan, and the couple got engaged.
Things seemed to move fast for them and the fans, leaving much to be desired. When the problems started, we barely had time to adjust to the marriage.
Sadly, fans said goodbye to Maggie and the union in Season 19. The divorce papers delivered to Winston in Season 20 gave us a much-needed, if awkward, resolution.
Simone Griffith and Lucas Adams
Simone and Lucas are two of the newest residents to join the ranks of Grey’s. Fans have paralleled their love story and that of Derek and Mer.
It’s no surprise, given Lucas’s DNA. He is Derek’s nephew, after all. He has greatness in his genes.
Lucas has been in love with Simone since they met.
And Simone was engaged to someone else. The wedding almost happened, but Simone called it off at the last minute.
No one, including the couple, seems to know where they stand. If things can work out, we might have our next true love story.
What do you think of this list of the greatest relationships on Grey’s Anatomy? Is there a relationship we didn’t include that you like?
Be sure to comment with your pick for the best couple.
Sara Trimble is a staff writer for TV Fanatic. You can follow her on X.