This study tested the hypothesis that marital distress has a significant effect on health care utilization for older couples. Results from 536 intact couples in long term marriages showed men in dissatisfying marriages are more likely to utilize health care services; women in satisfying marriages are more likely to use health care services. There were no significant partner effects of marital quality on health problems or health care utilization. The association between husbands’ marital quality and wives’ health care utilization approached significance. Implications for future research and clinical practice, including gender differences, are discussed.