The Grey's Anatomy couples have been as integral, if not more so, for the success of the long-running medical drama than the cases and major life-altering events at Grey Sloan Memorial Hospital every season. Grey's Anatomy starts with new residents - Meredith Grey (Ellen Pompeo) and Cristina Yang (Sandra Oh), the most notable - starting work at the hospital, dealing with patients and challenging cases, and trying to earn their spot in the hierarchy of the hospital. However, it is also a romantic drama.

From the beginning, Meredith fell for the hot Dr. Derek Shepherd (Patrick Dempsey), also known as McDreamy. That was one of the most endearing romances in the series. However, after over two decades, it isn't the only one, and even Meredith had other notable relationships on the show, both before and after McDreamy. From Meredith and Cristina to Izzie, Lexie, Sloan, Richard, and more, the romances capture fans' hearts while the medical cases simply add to the mix.

20 Meredith Grey and Andrew DeLuca

It Ended When Meredith Decided He Was Too Much Like Her Father

While Meredith and Derek will always be one of the best Grey's Anatomy couples and one of the best Grey's Anatomy married couples, it's hard to deny the strong feelings that Meredith and DeLuca develop for each other. They start dating in season 15 after Derek's death. It all started with a kiss at Jo and Alex's wedding, and they finally decided to date after a moment in the elevator, where they almost kissed again, but it only resulted in the two speaking Italian to each other in a romantic moment.

That was the start, and the two had a sweet relationship. However, they broke up when Meredith decided DeLuca acted too much like her father. Things ended in a heartbreaking moment, as, just like Derek, DeLuca died, sharing a moment in Meredith's beach scenes. While the characters dated for a shorter period than some other Grey's Anatomy couples, they cared so much about each other, and it was good to see Meredith happy after all the loss she had experienced.

19 Izzie Stevens and George O’Malley

The Friends Cheated, Causing George's Divorce

While Izzie and George were certainly a couple that no one saw coming, it was interesting to see them together. However, there was one major problem with the two hooking up. They had one of the best platonic friendships on the show. Hooking up ruined that friendship. George had eloped with Callie, and that is when Izzie decided she wanted more from him than just friendship. This causes them to hook up after a night of drinking, leading to Callie and George's divorce.

Taking away the infidelity from the situation, George and Izzie could have made their relationship work since they had been such good friends and had a strong connection.

Taking away the infidelity from the situation, George and Izzie could have made their relationship work since they had been such good friends and had a strong connection. They also seemed to be the only two characters who knew how to make each other laugh and appeared comfortable in each other's presence. If it wasn't for Izzie's unresolved feelings for Alex, the writers may have revisited this in the future.

18 Amelia Shepherd and Atticus Lincoln

Amelia & Atticus Have A Son Named Scout

Amelia and Link were friends before starting their Grey's Anatomy relationship, and while Link was always confident that he loved her, Amelia took more time to it her feelings. Amelia struggled to be vulnerable with Link, while Link had always known. However, when the relationship started, it was one of the best on the show. They seemed perfect until she got pregnant and would never it he was the dad during the pregnancy. When he proposed to her at someone else's wedding, it was a bad sign.

After they split up, Jo and Link sleep together, and Jo says that she likes him, effectively showing that their relationship has not completely ended. While it was sweet to see Jo happy again after Alex ended their marriage without a word and moved away to be with Izzie, some fans still think Amelia and Link had a great bond and could make things work. They definitely had one of the most dramatic Grey's Anatomy relationships.

17 Cristina Yang and Preston Burke

Preston Left Cristina On Their Wedding Day

This was a fan-favorite relationship from the beginning. It was a bit of a surprise when Cristina and Burke initially got together, but from there, everything made sense. Burke seemed to bring out a softer side in Cristina, and she helped him see that it was okay to want more than just a great career. There were so many great moments they had together, with Cristina risking everything by helping him cover up his hand tumor and him caring for her after her ectopic pregnancy.

The couple eventually ended their relationship after two seasons when Preston left her on their wedding day. However, despite the rough ending, Cristina still didn't regret their experience together, as it gave her perspective on what she did and didn't want in a partner. Fans also appreciate the relationship because it lets Cristina's character develop. Preston founded the Klausman Institute for Medical Research and gave it to Cristina when he and his family left Switzerland.

16 Teddy Altman and Henry Burton

A Fake Marriage Turned Very Real

While it may have started as a fake marriage to give Henry health insurance, it wasn't long before these two characters fell in love. After she had been in love with Owen for years, it was great that Teddy seemed to be moving on with Henry, as it was hard to ignore the chemistry between the two. Not only did Henry and Teddy find new ways of making each other laugh with their wit and charm, but it was also quite endearing to watch as their faces lit up whenever they were in each other's presence.

Unfortunately, this ended tragically, as Henry sadly died while he was on the operating table. Although fans knew he wasn't a main character, it was still devastating to watch - particularly in the aftermath, as Teddy's grief overwhelmed her. This all happened in Grey's Anatomy season 8, and it was one of the saddest moments on the show, with Teddy finally finding love and then having it slip through her hands.

15 Owen Hunt and Teddy Altman

The Two Actually Married Despite Roadblocks

It may have taken them a while to get to the end, but Owen and Teddy finally got their happy ending, making them one of the best Grey's Anatomy couples. While the two have been a part of other great and iconic relationships, many fans will agree that this is the one that makes the most sense, as they both have the same desires and hopes for the future.

While it did look as if the couple might have broken up for good after Teddy's affair with Tom, it appears that their relationship has become stronger, as both Owen and Teddy realized they shouldn't take each other for granted. Since their romance is also built on years of friendship, it's nice to see that their connection hasn't wavered. No matter what they have been through, they always have each other's backs.

14 Lexie Grey and Jackson Avery

Jackson Shockingly Chose Mark Over Lexie

This was a really fun couple for fans, as there wasn't so much at stake. Jackson seemed to love Lexie, but Lexie couldn't truly reciprocate because of her feelings for Mark. It was pretty apparent that Jackson was mainly a distraction for Lexie, and because of this, fans didn't let themselves get too attached since this happened after one of Lexie's numerous break-ups with Mark. This seemed disappointing since their time together on Grey's Anatomy was always fun, and they seemed like a great couple.

It's too bad, though, because Lexie and Jackson could have been great together had they given it a real shot. Surprisingly, Jackson ultimately breaks up with Lexie (rather than the other way around) when he chooses his job over their relationship. Most fans saw Lexie ending things thanks to wanting to go back to Mark, so the plot twist of Jackson being the one to choose Mark (and a new job) over Lexie was a huge shock. It was a good decision since Lexie was never all-in on the relationship.

13 Maggie Pierce and Winston Ndugu

The Two Seemed Perfect For Each Other

While they weren't together as long as some other couples on the show, Maggie and Winston made quite an impression on fans. It may have felt like a love story that came straight out of romance novels, as the two had met in season 16 and then finally came back around and fell in love, getting married. Not only does Maggie seem less stressed and relaxed, but Winston also seems to understand her on a level that none of her former partners did.

Maggie deserved to be happy after enduring several tragic events and terrible relationships (she was with DeLuca and Jackson before this). However, that all changes in season 20 when she makes a shocking decision. Maggie chose work over love, which showed that she wasn't looking for true love at all. When Winston said he put love over surgery, she said she couldn't respect him for that decision, and she chose divorce since surgery, for her, comes before all love.

12 Derek Shepherd and Addison Montgomery

They Were Divorced When The Show Started

When Grey's Anatomy started, Dr. Derek Shepherd (Patrick Dempsey) and Dr. Addison Montgomery (Kate Walsh) were estranged, but were both brilliant doctors on staff at the hospital. Shepherd was the head of neurosurgery, and Addison headed up the surgical wing. However, while they were not together when the show started, the sexual chemistry between them was high, and that was one thing that really delayed Derek and Meredith from finally getting together.

Derek and Addison did try to get back together on the show, but Addison knew the truth. She said that Derek and Meredith were in love and that was the couple that was meant to be together - not their old marriage. With that said, Derek and Addison were great together as lovers, as friends, and even as bitter enemies, and the show was always better when both of them were involved in each other's lives in one way or another.

11 Jackson Avery and April Kepner

The Two Remain Together In Boston

Jackson and April's romance is arguably one of the most complicated love stories in the history of Grey's Anatomy, as it seems they just couldn't get the timing right. However, when they were together, they did seem like a natural fit. They may have had opposing beliefs (initially) and went through some traumatic experiences that led to their breakup, but the connection they had never wavered.

The two got married in season 10 before splitting up. However, with them rekindling their relationship in Boston in season 18, there are high hopes that this is a race one that could actually work in the end. With them together in Boston, and Jackson working for the Catherine Fox Foundation, there is hope that the Grey's Anatomy writers will create a spinoff that follows up on their adventures. They were always one of the best Grey's Anatomy married couples.