Healthy romantic relationships are beneficial to an individual's physical and mental health. The prevalence of long-distance relationships (LDRs) is increasing; yet, no research has assessed whether the marriage–health association applies to individuals in LDRs. The present study investigated the marriage–health association in LDRs by comparing PR and LDR individuals on various health and relationship indices. Using both Qualtrics and Amazon's Mechanical Turk, we designed an online survey (N = 296 married, 21 years or older, English speakers). Health measures included the patient-reported outcomes measurement information system (PROMIS-29); Perceived Stress Scale; and substance use, diet, and exercise surveys. Relationship variables assessed included satisfaction, maintenance, relationship stress, and sex. Overall, results were mixed, with no clear relationship arrangement relating to better health or relationship variable ratings. Relationship satisfaction did not differ across groups; however, individuals in PRs reported better maintenance, higher sexual frequency, and lower relationship stress. In terms of health, LDR individuals reported better health on several indices: overall scores; lower anxiety, depression, and fatigue subscale scores; and better diet/exercise behaviors. PR individuals reported lower individual stress levels, better medication adherence, and higher physical functioning scores than their LDR counterparts. Regression analyses indicated being in a LDR predicted more individual and relationship stress but simultaneously better diet and exercise behaviors. This study challenges the popular notion that health and happiness in a relationship stem from partner proximity and provides potential points of intervention to improve relationship satisfaction and health for individuals in both PRs and LDRs.