Photo-Illustration: Vulture and Photos by ABC

On Grey’s Anatomy, love is always in the air. Much like some kind of airborne super-virus, no one at Grey Sloan Memorial is safe. Surgeons, nurses, paramedics, and patients have all fallen victim to this contagious disease. No matter how much hand sanitizer you use, love will find you. Since dating at Grey Sloan is as ubiquitous as some panicked scrubs-clad surgeon yelling, “We have to get her into the OR now!” and since it is the Season of Love, as it were, Vulture took the time to look back and rank all the couples who have tried to make this love thing work on Grey’s Anatomy.

Before we get into whose flame burns eternally and whose we wish had never been lit at all, some ground rules: We’re only talking couples that feature at least one employee of Grey Sloan Memorial. It has to be more than just hooking up (sorry Callie and Mark and Cristina and Shane), and we have to see some of their relationship play out (Cristina and Dr. Marlow and Jo and Paul Stadler are out). We may so badly want to write about how Owen and Teddy are MFEO, but aside from some ill-timed kissing, they haven’t gone for it, so we can’t. And we’re not necessarily ranking based on who is the happiest, healthiest couple. Happy never hurts (take notes, Amelia and Owen), but we’re taking a few other things into consideration: We’re ranking couples based on passion, chemistry, importance to the Grey’s Anatomy canon, and how captivating their love story is.

We’re trying to separate the iconic Grey’s couples, whom we would root for no matter how tragic they become, from the garbage-fire couples who should have never gotten together in the first place. Yay, love!

50. Jo Wilson and Jason Myers

As if Jo Wilson needed another terrible man in her life after she escaped a marriage of domestic abuse. Unfortunately, the guy she chooses to date in order to make Alex Karev jealous is also abusive. Jo fights back and puts him into a coma. After Alex threatens his life and career, the ob-gyn is never seen or talked about again. It’s better that way.

49. Arizona Robbins and Eliza Minnick

Arizona Robbins has chemistry with pretty much everyone. (How many hot lesbians have shown up and immediately fallen in love with her?) So it is confusing when she has zero chemistry with the universally disliked Dr. Minnick. Arizona needed some romance but THIS WAS NOT THE WAY.

48. Callie Torres and Penny Blake

Was Penny’s greatest Grey’s sin that she didn’t fight hard enough to get Derek a CT scan, effectively murdering him? Or that she showed up at Grey Sloan, started dating Callie, and turned the doctor we’ve known since season two into a completely different person — one who would put everyone (audience included) through a terrible custody battle so that she could move across the country to be with someone she has no chemistry with? Killing Derek is bad, but the latter is straight-up ridiculous.

47. Owen Hunt and Amelia Shepherd

At one point, early in Owen and Amelia’s relationship, Owen says, “I won’t survive another plane crash, Amelia. And that’s all that we are.” Amelia and Owen are two broken people running from pain and loss who find one another. Sometimes that can be romantic. This time, however, Owen’s right: It’s just a plane crash. The show attempts to retcon the entire shrieky relationship by blaming all of Amelia’s actions on a brain tumor she’d had for ten years, but that somehow makes it worse. Relationships, as this show proves, can be tragic and romantic, but there’s nothing emotionally moving about watching a couple who make each other miserable the entire time they are together.

46. Izzie Stevens and George O’Malley

Hard pass.

45. Izzie Stevens and Hank the Hockey Player

Okay, this relationship doesn’t survive the pilot episode, but per the rules, Hockey Player boyfriend must be mentioned. What a dope! Izzie is better off without him. The guy doesn’t get her medical internship life and is barely memorable. Boy, bye.

44. Maggie Pierce and Clive, a.k.a. Chive

This relationship is extremely new and definitely won’t last, but good on Clive for planting a big, passionate kiss on Maggie, even if she is too distracted to notice. Maggie will most assuredly dump poor Clive for Jackson, but maybe she shouldn’t be so quick to ditch this guy! Who knows what wonders Clive could hold?

43. Maggie Pierce and Ethan Boyd

Radiologist Ethan Boyd is Maggie’s first foray into the Grey Sloan dating pool. He’s very cute and patient, but this fizzles out pretty quickly. Not long after, Ethan ends up getting married and Maggie seeks comfort in Andrew DeLuca’s arms. Everybody wins!

42. That intern love triangle from season five

Okay, okay, their names are Pierce, Megan, and Steve, but does anyone even care? All they really do is cause Meredith and George a whole lot of trouble for one day as they sort out their drama. In the end, Megan is in love with Steve and pregnant with his baby and eventually they get married. Good for them, inconsequential to us.

41. George O’Malley and Olivia Harper

The worst thing about this relationship is not that Olivia gives George Alex’s syphilis. The worst thing is that George ends it by saying, “I like you, Olivia. I just don’t like you enough.” That is way harsh.

40. Teddy Altman and Andrew Perkins

For two hot people, this relationship sure is a snooze.

39. Alex Karev and Lucy Fields

Lucy is Alex’s first real girlfriend after the one-two punch of Rebecca/Ava and Izzie. It all seems like a nice, normal relationship until Lucy goes and steals Alex’s opportunity to work in Africa. There wasn’t a ton of passion here to begin with, but still, that’s cold.

38. Andrew DeLuca and Sam Bello

In all fairness, we’ve only scratched the surface with these two. They have a destructive history and they are currently repeating that pattern. They spend their time having sex, not sleeping, and seducing each other with loud chewing. Cool! At this point, they are mostly annoying, but the jury is still out.

37. Meredith Grey and William Thorpe

On paper, Thorpe is great. He’s a soldier who is also a surgical oncologist. He is a hunk with a dark side. He is cool with going on a date that consists of simply eating French fries in his car. Unfortunately, he shows up much too early. Meredith is nowhere near ready to begin dating after losing Derek. Thus, Thorpe’s time is short-lived.

36. Mark Sloan and Teddy Altman

The good doctors Sloan and Altman enter into this short-lived relationship wanting completely opposite things: Sloan, urged by BFF Callie, is looking for a serious, adult relationship that includes dates in the light of day. Teddy just needs a good lay. Fortunately, they both get a little of what they want! The sex is good, the daytime conversations are surprisingly nice, but ultimately these two aren’t very compatible.

35. Callie Torres and George O’Malley

Pro: Callie was Callie O’Malley for a little bit and that is hilarious. Con: The chemistry between George and Callie was always a little bit off. Callie pretty much spent the entirety of this relationship telling George she loved him and not getting a response, dealing with judgy looks from George’s judgy friends (I love them, but they are judgy), helping George deal with the death of his father, and then getting cheated on by George. Callie got a raw deal, you guys.

34. Mark Sloan and Julia Canner

Well, this is a unicorn: Mark Sloan in a stable, adult, non-tragic relationship. Julia is a talented eye surgeon who loves Sofia, loves Sofia’s moms, and loves Mark. They even start talking about building a family together — all of Mark’s dreams are coming true. Except all of Mark’s dreams include Lexie. These two are technically still together when Mark and Lexie’s plane crashes, but even if that didn’t happen, Julia never stood a chance against Lexie.

33. Owen Hunt and Emma Marling

Emma is perfect for Owen! She is sweet and kind. She is an excellent maternal-fetal surgeon. She volunteers to cook Thanksgiving dinner even though we all know that is legit crazy. She also wants to have a family. Which, to our knowledge, is all Owen has ever wanted in life. It’s what drove an insurmountable wedge between Owen and Cristina. Only, when Emma tells Owen that she’d like to have three kids and she’d leave her job to raise them, his brain is mysteriously replaced with that of a coldhearted alien. He thought he wanted kids, but now what he wants is a partner who is just as committed to her job as he is. Owen is insufferable in this moment and Emma, girl, you’re better off without the guy.

32. Callie Torres and Erica Hahn

Callie and Erica are important because their relationship helped Callie come out as bisexual and also because it meant we got to see Mark Sloan repeatedly ask for a three-way. He’s a dog, but he’s our dog! There was chemistry between them, obviously, but Erica was never THE ONE for Callie. So when Hahn walked off into the Parking Lot of the Unknown, it wasn’t a huge loss.

31. Lexie Grey and Alex Karev

You know those things where while the thing is happening you are super okay with it and it seems like it works and then you think back on that thing years later and you’re like, “Holy hell, that seems like a terrible idea, why would I ever do that?” That’s pretty much Lexie and Alex.

30. Miranda Bailey and Tucker Jones

We never really get to see the romantic side of Bailey’s first marriage, only its destruction. Tucker isn’t around much, but the relationship is extremely important to Bailey’s character development. She was pretty broken post-divorce (what kind of man gives Dr. Miranda Bailey an ultimatum?!), and you can still see those effects today. Bailey learns a lot about herself through her time with Tucker, getting her ready to meet the true love of her life (squeeeee), and we as an audience get to see a more vulnerable side of her for the first time.

29. Alex Karev and Rebecca/Ava

I am very much here for inappropriate doctor-patient love stories, but Alex and ferry-boat-crash victim and facial-reconstruction patient Rebecca-also-Ava was always a disaster. It made sense that Rebecca would deal with the intense amount of trauma she faced by falling for Alex, but Alex should’ve known better. Especially when she starts showing up out of nowhere and convinces Alex (and herself) that she’s pregnant, but is clearly not. Poor Alex! Poor Rebecca/Ava! This relationship was never going anywhere, but it’s also hard to forget.

28. Maggie Pierce and Andrew DeLuca

Like Tyra Banks before me, I was rooting for them. It was good for by-the-book Maggie to spend some time schtupping an intern. He ends up breaking things off because people treat him differently once they know he’s an intern sleeping with the head of Cardio, but honestly, I wouldn’t hate it if they revisit things down the road. They probably won’t, but one time a kid came into the hospital after being impaled by a tree so, you never know.

27. Miranda Bailey and Eli Lloyd

Let’s call this one How Miranda Bailey Got Her Groove Back. Eli leaves Bailey dirty notes in charts, introduces her to the wonders of the on-call room, he makes Bailey laugh. No-nonsense Bailey! Not to mention, Hot Nurse Eli is extremely good at his job, has the voice of an angel, and is very much there for Bailey when she gets upset after a plane crashes in the Sound. Eli is great and should he make a surprise return to snatch up some other eligible doctor, I would not hate that.

26. Arizona Robbins and Carina DeLuca

It’s only early days in this relationship, but Arizona and Carina have potential to be a long-lasting Grey’s couple. They are super-hot together, they started out casual and after being apart realized they wanted something more, and now they are working together to fix the maternal mortality rate in the United States. Undeniable chemistry, an unstoppable attraction to one another, and working together to make a major medical breakthrough? How very Meredith and Derek of them, no?

25. Stephanie Edwards and Jackson Avery

This is another Grey’s couple that, aside from an intern dating her boss, seems perfect on paper. But Jackson’s heart is never truly in this, and as a result, it’s hard to root for. They are only memorable for how they ended.

24. April Kepner and Matthew Taylor

Are there two more compatible people in the Grey’s Anatomy universe? Even the other doctors call paramedic and flash-mob proposer Matthew Taylor the boy version of Kepner. They share the same Christian values and wholesome good looks. They do not, however, agree upon whom a bride is supposed to flee the church with on her wedding day. And some things couples just can’t get past.

23. Meredith Grey and Finn Dandridge

Oh, McVet. McVet is a very nice man who can heal animals. McVet is very handsome. But McVet is only an obstacle. McVet is a plot device to prolong the inevitable reunion of Meredith and Derek. McVet is very dreamy but he isn’t McDreamy, you know?

22. Derek Shepherd and Nurse Rose

If I were the fanfiction-writing type, I’d be writing novels about how one day the very nice Nurse Rose runs into a very nice veterinarian named Finn and they laugh and laugh about how they ever thought they had a shot at breaking up the eternal love of Meredith Grey and Derek Shepherd and then they fall in love and have very pretty children and probably three dogs. Rose and Derek seem pretty great together, but come on. Let’s all be honest with ourselves here.

21. Meredith Grey and Nathan Riggs

Grey’s Anatomy tried real hard to get Meredith a post-McDreamy love, and as the Meredith and Riggs romance showed, maybe a little too hard. Nathan was a great character, and their hookup in the hospital parking lot was [insert chef’s kiss], but their greatest commonality was the grief they were still feeling for their respective soul mates. This was always a relationship of four people. Thankfully, Grey’s doesn’t fight for it too hard, and it ends in exactly the right way.

20. Lexie Grey and Jackson Avery

Lexie and Jackson, beautiful humans and capable doctors, get together during one of Lexie’s numerous breaks from Mark. There was never much hope for them, which is a shame because they are a great pairing. Plus, it starts out with Jackson saying dreamy things about how there’s a line of guys waiting for Lexie if she would just get over Mark, and he is most definitely in that line. Also, laundry-room sex! Alas, the power of Mark Sloan was too great to make this work, but in a surprise twist, it is actually Jackson who chooses Mark over Lexie — the Plastics Posse is more important to him than fighting for a woman who doesn’t really want to be with him anyway. The Plastics Posse. Now that’s true love.

19. Nathan Riggs and Megan Hunt

What drama! After ten years, Megan Hunt turns up alive and she and Riggs are still very much in love. It’s a testament to the show and to Martin Henderson and Abigail Spencer that people were so invested in the love story of two minor Grey’s characters. But oof, is this a good love story. After trying to fight it, Nathan, Megan, and her adopted son, Farouk, end up holding each other as the waves crash around them on a sunny beach in California. That’s about the happiest ending ever produced from Grey’s Anatomy.

18. Cristina Yang and Owen Hunt

It starts with a violent PTSD episode, in the middle they get married for all the wrong reasons (although Cristina’s red wedding dress is so, so right), and it ends over and over again because they love each other but want different things. This may be a controversial placement on the list because this relationship was such a big part of the show, but did Cristina and Owen ever seem that happy together? Their breakups and makeups grew repetitive, especially since neither were ever going to change who they really are.

17. Callie Torres and Arizona Robbins

This relationship is a tough one. It’s one of the longest on Grey’s Anatomy. It is the show’s first long-term same-sex couple. Callie and Arizona make each other better people … until they don’t. The two are never the same after Arizona loses her leg in the plane crash. They fight admirably to save their marriage, but only end up hurting each other over and over again. Let’s be real: A lot of it is Arizona hurting Callie with guilt and an affair and Callie taking it like a punching bag. They were, however, easy to root for, until they weren’t. They aren’t as toxic as Amelia and Owen, but is that even saying anything?

16. Cristina Yang and Surgery

The purest love depicted on this show.

15. Derek Shepherd and Addison Montgomery (Shepherd)

Even when these two hate each other, they are good together. They are hotties. They have history. Their chemistry is off the chain, as the kids say. However, as Addison so eloquently puts it while she and Derek are attempting to make their marriage work: “The only people who don’t know Derek and Meredith are in love are Derek and Meredith.” This couple is another that falls victim to the unstoppable force of Meredith and Derek’s story. The only difference: This one really hurts. In some alternate universe, Derek actually fights just a tiny bit for Addison and those talented beauties make things work. I’m not saying I want to live in that universe, I’m just saying it exists and that’s nice.

14. Mark Sloan and Addison Montgomery

Am I cheating a little because Mark and Addison were never, at any point “official” official? Sure. But Mark and Addison are such an integral, iconic Grey’s pairing that it felt wrong not to include them. Plus, they were straight fire together.

13. Alex Karev and Jo Wilson

I feel like a very big person for ranking these two so high even though I am personally not a fan. However, I am able to look beyond personal preferences because in the Grey’s Anatomy canon, Alex and Jo are important. We’ve watched Alex suffer for a very long time, and if this is how he gets a happy ending, so be it. Also, one time they made out against a barn and it was steamy.

12. Stephanie Edwards and Kyle Diaz

This doctor-patient relationship is the mini-version of Izzie and Denny. Stephanie and Kyle don’t get as much time or focus as the OGs, but they have a similarly intense connection. These two are so good together, even knowing that Kyle’s a goner from the moment we meet him doesn’t ease the pain when he finally dies in surgery after complications from his MS. Remember when he takes her to his music studio? Swoon.

11. Richard Webber and Catherine Avery

Everyone is encouraged to go back and watch “Moment of Truth” in season eight, when Richard and Catherine sleep together for the first time. Not only is it refreshing that Grey’s doesn’t back away from sex scenes with characters over 50, but, you guys, it is hot. Richard and Catherine are such a great couple because they are so evenly matched. They are both, one might say, serious catches. I mean, would The Catherine Avery make a giant romantic proposal in the middle of the hospital for just anyone? The have some major fights but overcome them. They are flirty and happy, and I swear if Grey’s messes with them in any kind of permanent way, heads will roll.

10. Teddy Altman and Henry Burton

Please don’t make me talk about this one, it happened way back in season eight, but I am still not over it. Teddy and Henry are your typical “boy has chronic illness and no health insurance, boy meets doctor with health insurance, boy and doctor get married for insurance reasons, boy and doctor fall in love, boy dies” tragic romance story. They get precious little time together, but even so, they are one of the most supportive, loving couples in the show’s history. Henry is inspired to go to medical school, and even though Teddy hates the idea, she promises to have his back. Henry makes Teddy happier than we’ve ever seen her, thank you very much, Owen Hunt. They are in such a lovely place when Henry suddenly dies on Cristina’s surgical table. WHYYYYY. Teddy and Henry weren’t together long, but boy, were they memorable.

9. Izzie Stevens and Alex Karev

I firmly believe that if Izzie had stuck around Seattle, the Izzie and Alex romance would be as iconic as Meredith and Derek. They start off hating each other, realize there is much more to the other person than originally thought, and endure several romantic tragedies before finally finding one another for real. For, like, married real. Not to mention, together they are the best versions of themselves. Serious question: What is most swoon-worthy, Alex lifting Izzie up off of Denny’s dead body and holding her close to him OR Alex’s endearing and sincere monologue about how he imagines Izzie getting her happy ending after all these years? Can you even choose?

8. Richard Webber and Adele Webber

Does anyone not tear up just thinking about the time when Adele, suffering from Alzheimer’s, is having an episode in the hospital, and Richard, in the middle of surgery, sings “My Funny Valentine” to her while she stands crying in the OR gallery, in order to calm her down? BRB, I have something in my eye.

7. Mark Sloan and Lexie Grey

Mark and Lexie are undoubtedly Grey’s Anatomy’s star-crossed lovers. They are each other’s destiny, but just can’t seem to work out the timing. No one else stands a chance against them (okay, maybe, maybe Addison, if she hadn’t hightailed it to California). But the timing is always, tragically, off — to the very end. Mark is with Dr. Julia, but Lexie is so overwhelmed with her feelings that she lays a big romantic speech on Mark about how she can’t sleep, she can’t eat, she can’t breathe. Mark is in her. Days later, Lexie dies in the woods and Mark follows not long after. Here’s hoping these two soul mates made it work in the next life.

6. Richard Webber and Ellis Grey

Would we even be here if it weren’t for Ellis and Richard’s forbidden love affair? We do get to see their love (and heartbreak) on display in flashbacks, but the true testament to their connection comes when Ellis, afflicted with Alzheimer’s, sees Richard at the hospital and lights up. Richard is the only person who can calm her. When she returns to the hospital in a rare lucid episode, they get to say things they weren’t able to before. Richard doesn’t regret staying with Adele, but he also understands that telling Ellis this won’t help her situation. Instead, he holds her and tells her about the wonderful, happy life they would have had together. And then suddenly, she is gone again. Yes, this relationship is an affair, and it was wrong for Ellis and Richard to do this to their spouses, but that doesn’t make their love any less true, tragic, or memorable.

5. Jackson Avery and April Kepner

Uh, hello. This is #Japril. I don’t see Meredith and Derek getting their own catchy portmanteau, do you? And DO NOT come at me with MerDer or Merek or whatever nonsense you have. Yes, #Japril is divisive, but it is also undeniable. Their hookup in the bathroom during their oral boards in season eight is one of the hottest scenes in Grey’s Anatomy history, period. If you’re not onboard with at least that, um, maybe your eyes were closed during that episode? There’s no other explanation. It also doesn’t get much swoon-ier than Jackson standing up and professing his love for April at her wedding. “Say it loud and go from there!” They were broken people after the tragic loss of their son Samuel, but I have faith they will eventually find their way back to one another (they have to). Even if Jackson and April aren’t the endgame (as if), they will always be an iconic Grey’s couple. And they have two #Japril-centric episodes to prove it.

4. Miranda Bailey and Ben Warren

Miranda and Ben are arguably the best example of marriage Grey’s Anatomy has. Yes, they’ve had some downs — Bailey’s OCD, Ben’s impromptu fatal C-section, all the Church and State stuff, Ben’s decision to become a firefighter — but they always bounce back. If you had any doubt, their scene after Bailey comes out of heart surgery and Ben sees her for the first time is so full of emotion and love, I’m actually crying while typing this. And talking about how wonderful and loving their marriage is doesn’t even touch on how wonderful and loving their courtship was. Ben is able to push and encourage Bailey in a way others can’t, and Bailey helps keep Ben levelheaded. They just fit. And do not get me started on Ben’s speech to Bailey about how he wants the whole package. About how he knows who she is. DO NOT GET ME STARTED.

3. Cristina Yang and Preston Burke

Come at me! Cristina and Burke are only together for around two seasons before he dramatically leaves Cristina on their wedding day (let’s be honest: Burke was always a drama queen), but they are such a part of one another and such a part of this show, they blow so many other couples out of the water. He somehow makes a yellow turtleneck hot as he spoons Cristina after her surgery for an ectopic pregnancy. Cristina puts her career in jeopardy to help Burke hide his hand tremor after he’s shot. THEY DANCE IN THE KITCHEN TOGETHER. They are Cristina and Burke! She has other (longer) relationships, but Burke is so much a part of who Cristina is as a woman and a surgeon that when he pops up in season ten to lure Cristina away from Seattle, it just feels so right. No, they don’t end up together, but they are forever connected.

2. Izzie Stevens and Denny Duquette

The doomed doctor-patient love story of Izzie and Denny helped make Grey’s Anatomy what it was back in the early days. Millions of people know what an LVAD wire is because of Izzie and Denny. Their chemistry was so palpable and their tragic ending was so obvious that you couldn’t help but get wrapped up in their romance. Their entire relationship happens inside the hospital walls, but it feels so fully realized that you kind of forget. Izzie should know better than to get involved with a patient, but when Denny responds with a dimply smirk and a “good luck with that,” who can blame her? We all fell for Denny. Even though it is clear that Denny is a goner, his post–heart transplant “I get to choose now and I choose you, Izzie Stevens” speech is so romantic that you hope that the show gives Denny a last-minute reprieve. Although, if you’re honest with yourself, Izzie and Denny are such a memorable Grey’s couple because he dies. Izzie and Denny’s love is so strong that even in Meredith’s afterlife-coma situation, it is Izzie and Denny who are connected. Meredith doesn’t feel Derek, but Denny feels Izzie. What kind of bullshit is that? Unfortunately, the Izzie-Denny romance is a great of example of giving things their time and letting them go because Grey’s goes and ruins everything with the tumor-induced ghost sex, which we will speak of no more. Still, Izzie and Denny AAF!

1. Meredith Grey and Derek Shepherd

As if anyone else had a chance. Meredith and Derek are so much a foundational part of Grey’s Anatomy that when Derek died in season 11, people were fearful of how the show would go on without them together. I mean, obviously Meredith is a badass and doesn’t need a man, so the show is just fine (and sometimes better!) without its most iconic couple. But that doesn’t mean we weren’t blessed to watch them fall in love for 11 seasons. Callie puts it best when she tells a doubting Meredith that Meredith and Derek are “living proof that love exists.” That Meredith and Derek are “a frickin’ romance novel.” What’s the most romantic part of their story? The “Pick me. Choose me. Love me” of it all? When Derek makes an outline of the Dream House using candles? The elevator proposal? The Post-it note wedding? We watched them survive more hardships than most: failed trials, Addisons, almost-drownings, miscarriages, Derek’s beard phase, shootings, the president taking up all of Derek’s time, etc.

Thankfully, before Derek tragically meets his end, the two are in a very good place. They’ve been fighting for almost an entire season until finally Derek realizes that what’s most important is Meredith. He stops their fighting by “calling Post-it. And Zola. And Bailey. And tumors on the walls. And ferry boat scrub caps.” Now, if you’re not already swooning, check your pulse. He tells his wife that he can’t live without her, and more importantly he doesn’t want to. Before Derek dies, he realizes what the audience already knows: The most important day of his life (and ours) was the day he met a girl in a bar.