Lesbian and gay (LG) couples face a particular stress that is unique from their heterosexual counterparts: minority stress, the increased stress experienced as a result of living in an environment that is stigmatizing of their sexual orientation and identity. Research demonstrates that minority stress has far-reaching health implications for LG individuals. However, the literature examining the effects of minority stress on health at the couple level is limited. This study examined the impact of minority stress on emotional intimacy, relationship satisfaction, and psychological and physical health outcomes, as well as the moderating role of gender and marital status. A total of 181 LG-identified adults in same-sex relationships completed an online self-report survey. Results indicated that internalized homonegativity and sexual orientation concealment were negatively related to emotional intimacy and that emotional intimacy was positively related to relationship satisfaction. Emotional intimacy mediated the link between internalized homonegativity and relationship satisfaction for married—but not unmarried—individuals. Sexual orientation concealment mediated the link between sexual orientation concealment and relationship satisfaction for married men but not for any other group. Findings from the current study highlight the importance of emotional intimacy among individuals in LG couples. Areas for future research are explored, and implications for research, clinical practice, and policy are explicated.