Research shows that heterosexual spouses are concordant on a variety of health and health behavior outcomes. Yet, little is known about patterns of concordance between spouses in same-sex marriages, or whether concordance patterns differ for spouses in same- and different-sex marriages. Using descriptive techniques, we analyze survey data from both spouses in 121 gay, 168 lesbian, and 122 heterosexual married couples to examine health and health behavior concordance. We find that gay and lesbian couples are more concordant than heterosexual couples on several health and health behavior outcomes. Differences in concordance between gay and lesbian couples are also found. Findings suggest that the pathways through which concordance occurs may differ in important ways for same-sex and different-sex unions.