A substantial body of empirical evidence suggests that social relationships buffer people from poor health. We review a program of research demonstrating how interpersonal goals create relationship processes that shape the quality of close relationships, which we argue may have consequences for own and others’ health. Self-image goals to construct, maintain, and defend desired images of the self create negative interpersonal dynamics that undermine close relationships and mental health, while compassionate goals to support others’ well-being create positive interpersonal dynamics that promote close relationships and mental health. We discuss the potential implications of social goals and close relationship processes for health. Finally, we suggest that exploring the independent benefits of giving and receiving in close relationships may inform how social relationships affect health and well-being.