Objectives.Research on illness perceptions and their associations with psychological adjustment to medical conditions has mostly focused on individuals coping with chronic diseases. The objective of the current study was to expand this research to the study of couples by examining the perceptions of infertility among couples undergoing treatment and their associations with each partner's psychological adjustment.Design.The study was cross‐sectional and included two samples that differed in the stage of treatment: Sample 1 included 72 couples at their first visit to an infertility clinic and Sample 2 included 49 couples at various stages of treatment.Methods.Participants filled in the Illness Perception Questionnaire regarding the timeline, consequences and controllability of their fertility problem and Infertility‐Specific Distress and Well‐being Scales. Dyadic analyses were conducted on the basis of the Actor–Partner Interdependence Model (APIM).Results.The partners differed in their perceptions of infertility and their distress. Partners' psychological adjustment was related to their perceptions of the fertility problem. Among couples at their first visit, perceptions of consequences of both partners were additively related to their distress whereas controllability perceptions interacted in their association with women's distress: Highest distress was reported by women who perceived low controllability whereas their partner perceived high controllability, compared with couples who reported similar (high or low) levels of controllability.Conclusions.A dyadic approach to studying illness perceptions can uncover patterns of couples at risk for poor adjustment. This is especially needed in contexts such as infertility, where both partners are involved and affected by the health