||Posttraumatic stress disorder (PTSD) is associated with increased risk for cardiovascular disease and relationship difficulties. Greater exposure to couple conflict, and greater emotional and cardiovascular reactivity to such conflict, may help explain the link between PTSD and cardiovascular disease in veterans. Male veterans of Operations Enduring and Iraqi Freedom and their female partners participated. There were 32 couples in which the veteran had PTSD, and 33 control couples (veterans' age M = 33.7, SD = 7.4; partner's age M = 31.6, SD = 8.2; 92.3% Caucasian). Veterans completed the Clinician Administered PTSD Scale and the PTSD Checklist. All participants completed the Structured Clinical Interview for the DSM-IV-TR; Marital Satisfaction Inventory- Revised; Depression, Anxiety, and Stress Scale; and state anger and anxiety scales. Blood pressure and impedance cardiography were recorded throughout a conflict discussion. Compared to control couples, PTSD couples reported greater psychological distress, couple conflict, and disaffection (low warmth), and larger increases in anger in response to conflict. PTSD couples also displayed greater increases in systolic blood pressure and cardiac sympathetic activation in response to the stressor (all ps < .05; range η2: .066- .074). Partners in the PTSD group exhibited similar, if not greater, increases in negative affect and physiological responses as veterans with PTSD. This is the first investigation to document emotional and cardiovascular risks of couple conflict in veterans with PTSD and their partners. Anger and physiological responses to couple discord might be pathways linking PTSD to health risks, for both veterans and their partners.