This preliminary study explored the role of relationship with God in couples’ adjustment to the threat of breast cancer. Women and their partners were assessed on positive and negative relationship with God, perceived and received couple support, and depression and marital adjustment prior to the women receiving their biopsy results. Analyses were conducted on women and partners separately to evaluate individual adjustment. In addition, analyses were conducted to explore the transactional relationship between each individual’s relationship with God and the other’s support and well-being. In terms of women’s adjustment, a negative relationship with God and feeling a burden in the couple relationship predicted greater depressive mood. For partners, their relationship with God did not predict their personal well-being after controlling for various support measures. In terms of transactional couple adjustment, women’s relationship with God did not predict partners’ well-being. However, the partner’s negative relationship with God significantly predicted poorer marital adjustment for women after controlling for the partners’ marital adjustment and support measures. Findings highlight the potential impact of spiritual struggle in the couple’s adjustment to a stressor such as the threat of breast cancer. (PsycINFO Database Record (c) 2018 APA, all rights reserved)