Background: Mild cognitive impairment (MCI) signifies age-related memory decline that is less severe than with dementia. Most scholarship focuses on the clinical diagnosis and prevalence of MCI; the psychosocial aspects have been studied less often. Thus the purpose of this research was to examine the influence of MCI on interactions among long-term married couples. Methods: Using qualitative methodology, 10 spouses (5 wives, 5 husbands) of community-dwelling persons diagnosed with MCI reported on shared couple activities, amount of time spent together, division of household tasks, and management of everyday life. Transcripts were analyzed through an open coding process and results are represented by case studies. Results: The interviews revealed both stability and change within marital relationships when spouses are faced with MCI. Emergent themes focused on relational interactions (e.g., disclosure, negative and positive emotional outcomes, shared activities), relational dynamics (e.g., power, “couplehood”), socio-emotional intimacy (e.g., companionship, support, concern), and household responsibilities (e.g., external help, equal division of labor, spouse assumes most responsibility, person with MCI has assigned duties). Conclusions: Findings indicate that dealing with a spouse with MCI yields difficult emotional responses including helplessness, frustration, sadness, and worry. Spouses also expressed positive outcomes (e.g., commitment, love, emotional closeness) when discussing their relationship with their partner. Additional research is needed on the most effective coping strategies in the face of an uncertain prognosis and perceived changes in marital interactions. Practitioners should attend to the unique stressors and strains of having a spouse impaired by early memory loss and the potential for changing marital dynamics.