Thirty-four couples were interviewed to assess the congruity of husbands’ and wives’ perceptions of the wives’ osteoporotic pain and the exchange of instrumental support within the marital relationship. Moderate correlations were found between the husbands’ and wives’ ratings of two specific dimensions of the wives’ pain experience: interference with daily life and pain severity. Wives who perceived their pain as more severe but as having a lesser impact on their personal lives provided the most frequent help to their husbands. The wives’ pain perceptions were not predictive of the amount of assistance they perceived receiving from their spouses. Husbands’ perceptions of their wives’ pain experience were not predictive of the frequency of instrumental support they either received from or gave to their wives. © 1997 by the Women & Aging.