The aim of this research was to explore the experience and consequences of stroke amongst young adults and their spouses through semi-structured interviews and qualitative analysis. Individuals who were aged between 18 and 50 years, who had experienced a mild stroke and who were at least three months post-stroke, were eligible for inclusion. Individuals with persistent communication impairment, which would result in difficulties in taking part in an interview, were excluded. Patient participants acted as gatekeepers to the recruitment of their spouses. Fifteen individuals participated in the study, eleven patients and four spouses. Accounts of participants’ experiences were transcribed and analysed using Interpretative Phenomenological Analysis. Four super-ordinate themes emerged from patient accounts: (1) sudden and unexplained: will it happen again?; (2) changes in daily life; (3) trying to get better; and (4) relationship changes. Accounts from the spousal participants are encapsulated in the super-ordinate theme: loss and change. Findings demonstrate the ongoing difficulties experienced and negative impact stroke has on young adults and their partners. Ongoing cognitive impairments were a major barrier to carrying out daily activities, suggesting a need for greater recognition of such impairments among rehabilitation staff. Greater support is also required for spouses of young adults with stroke. Despite persistent difficulties, positive consequences of stroke were reported both by those directly affected and their spouses. Relationships were changed both positively and negatively following stroke. Insights gained in the current research contribute to a richer and more balanced understanding of the implications of stroke for young couples.