This study explored the effect of chronic debilitating illness on the quality of marital relationships. Twenty couples participated in qualitative interviews. Diagnosis and time duration of the illness, and demographic data were obtained. Subjects were asked to tell the researcher what it had been like for them as a couple to deal with the chronic illness. Couples must have been married for at least 5 years, must have one or both spouses or a dependent child affected by a chronic debilitating illness which had been diagnosed for at least 6 months and was not yet in the terminal phase, and both spouses were required to participate;Analysis of the data revealed the following: Couples who experienced areas of marital distress prior to the onset of the illness experienced an increase in their marital distress after the onset of the illness. High levels of individual stress did not correlate with high levels of marital stress or affect the level of quality of the marital relationship adversely. Roles were altered to accommodate the physical and emotional changes which occurred with the illness, but few power changes occurred. Illness which caused mental/emotional changes in the spouse created more marital distress than did illness which was more limited to physical alterations in functioning. Couples for whom illness created financial hardship experienced the highest levels of individual stress, but not necessarily increased marital stress. A satisfactory and high quality marriage served as a resistance factor, assisting spouses to cope with the illness;Certain family typologies and a strong religious or philosophical faith in a positive meaning of life experiences correlated with high marital satisfaction and quality. Social institutions, family and friends could serve as added stressors or as resistance factors. The majority of couples believed that the end effect of the illness on their relationships was to make them stronger, with increased bonding and appreciation of each other, often after an initial decrease in marital quality. Couples who experienced decreased satisfaction and lower levels of marital quality were those who had deficits in communication and affectional exchange and several areas of unresolved conflict prior to the illness.