Summary

• Izzie and Alex's relationship is unexpected but heartfelt, and their obstacles and arguments make for unforgettable moments in Grey's Anatomy.
• Alex initially exposes Izzie's modeling photos, but as their relationship progresses, he starts to see her confidence and they bond over their shared ambition to become successful doctors.
• Despite their ups and downs, including a lackluster first date and Alex's infidelity, Izzie and Alex eventually find their way back to each other and have a happy ending, although it is still an emotional journey.

Izzie Stevens (Katherine Heigl) and Alex Karev's (Justin Chambers) complicated, long-term relationship is one of the most memorable love affairs in Grey's Anatomy. At first, their romance is unexpected, as they don't get along as interns at Seattle Grace Hospital, but the characters both come from broken homes and share a desire to become successful doctors. Grey's Anatomy is known for featuring characters who fall in love as a result of the proximity of working together, but there's something special and heartfelt about this particular couple. Their obstacles and arguments make up some of the most unforgettable moments in the long-running medical drama.

While the series largely focuses on Meredith Grey and Derek Shepherd's romance, Izzie and Alex have a significant love story as well. They separate for a large portion of the Grey's Anatomy timeline but do find their way back together. While Meredith (Ellen Pompeo) has to say goodbye to her soulmate Derek (Patrick Dempsey), Izzie and Alex eventually have a happy ending, although one that is just as emotional as the rest of their interactions.

Season 1, Episode 1, "A Hard Day's Night"

Izzie And Alex Meet As Interns

In the pilot episode of Grey's Anatomy, Izzie, Alex, Meredith, George O'Malley (T.R. Knight), and Cristina Yang (Sandra Oh) meet as interns. Most of the focus is on Meredith since the series is built around her character, and eventually, her family, hence the title. By extension, Cristina gets a focus since she is Meredith's "person." George, Izzie, and Alex, however, also get brief introductions in the pilot before their characters are expanded upon during the rest of the first season.

There is no indication that there are any sparks between Alex and Izzie. They both appear a little cold and focused on their new careers, and they don't take the time to get to know each other. This first impression is important as in a few episodes, Izzie and Alex will see each other in a different light, which will allow them to bond.

Season 1, Episodes 2-9

Izzie And Alex Focus On Their Internships, He Exposes Her Modeling Photos

In season 1, episode 2, "The First Cut is the Deepest," Izzie shows she can be a good doctor when she works on her first big case. Alex and Izzie don't interact much for a few episodes, but in episode 4, "No Man's Land," he reveals photos of Izzie as a lingerie model for Bethany Whisper to the hospital. Izzie shows her strength in being proud of making money to herself through medical school while Alex realizes he shouldn't be so judgmental and immature.

The release of Izzie's photos by Alex isn't exactly a turning point for their characters, but it does plant the seeds of a connection between them as they both learn from the experience. Though Izzie and Alex continue to bicker during these episodes, Alex also starts to see Izzie's confidence in her abilities.

Season 2, Episodes 1-3

Alex And Izzie Bond And Work Together

In season 2, episode 1, "Raindrops Keep Falling on My Head," Alex and Izzie start flirting with each other. Their flirtations lead to them working better together as well. She helps him see that it's a smart idea to show patients more comion instead of simply focusing on diagnoses. As Alex is concerned about a patient Joe (Steven W. Bailey), who comes in after suffering from an aneurysm, Izzie realizes that Alex is sweeter than she thought.

It's during this set of episodes in season 2 that Alex starts to become more than just the stereotypical big man on campus, allowing Izzie to get to know him a bit more. As they get to know one another, they begin to genuinely care about one another. The path to becoming one of the best Grey's Anatomy couples begins when the characters can no longer ignore their feelings for each other.

Season 2, Episode 4, "Deny, Deny Deny"

Alex And Izzie Have A Lackluster First Date

Although Izzie and Alex are both intelligent and ambitious people, which should give them enough in common to start a happy relationship, they have a tough first date in season 2, episode 4, "Deny, Deny, Deny." Izzie is angry that Alex decides not to kiss her at the end, but he proves his stubborn and secretive nature when he doesn't it that he's upset about failing his board exam.

Though they both like one another, they aren't yet on the same page, or ready for a committed relationship. It's not unlike Meredith and Derek not being completely honest with one another during the early days of their relationship. The two of them aren't completely ready to be vulnerable and honest with one another. It still takes them a while to get to that point. While Izzie and Alex will learn to open up to each other, this is a rough point for them in Grey's Anatomy.

Season 2, Episodes 5-9

Izzie And Alex Share Their First Kiss And Are In A Happy Place

This is a turning point in Izzie and Alex's new relationship as she thinks that Alex doesn't have real feelings for her, and he is scared to be honest about what's going on. Alex is a fan-favorite Grey's Anatomy character because he realizes what he has done wrong and attempts to be a better person, and he knows that he has to explore his feelings for Izzie. Alex starts to grow quite a bit because of his relationship with Izzie and this is where that growth begins.

The romance seems to be going well at this point in the series

In season 2, episode 7, "Something To Think About" Alex becomes more courageous and kisses Izzie at Emerald City Bar. They kiss again at the hospital in season 2, episode 8, "Let It Be." The romance seems to be going well at this point in the series, though it doesn't progress particularly quickly just yet.

Season 2, Episode 10, "Much Too Much"

Alex Is Unfaithful And Sleeps With Olivia

While Alex appears to be growing up, he makes a mistake at the start of his burgeoning relationship with Izzie that creates a big setback for the two of them. He makes the mistake of sleeping with Nurse Olivia Harper (Sarah Utterback) as he's afraid of becoming too close to Izzie and having her reject him. He thinks by continuing to see other people, he won't feel as much for Izzie as he already does.

Izzie is understandably upset, and she and Alex appear to be over. However, since Grey's Anatomy is a drama where every couple breaks up and gets back together several times throughout their arc, it appears likely that the couple will find a way back to each other, even at this point in the series. Alex becomes a better Grey's Anatomy character after this intense plotline, as he knows that he was wrong and wants to be a loyal partner for Izzie.

Season 2, Episodes 11-20

Alex And Izzie Sleep Together But Remain Broken Up

Over the next few episodes of season 2, Alex and Izzie avoid each other at the hospital due to the hurt feelings and awkwardness that they're experiencing. They fall back on the same patterns that most of the couples in Grey's Anatomy do when they have a setback - avoidance and then hooking up before truly addressing their feelings. Most of their storylines are focused on the medical case of the week instead of each other.

In season 2, episode 16, "It's the End of the World", they are afraid when a patient comes in with a bomb in their chest and Izzie asks Alex if he will sleep with her since survival isn't guaranteed. That, however, doesn't mean that Izzie and Alex are back together. In season 2, episode 20, "Band-Aid Covers The Bullet Hole," Izzie has clear feelings for patient Denny Duquette (Jeffrey Dean Morgan), and she feels that she can move on from Alex.

Season 2, Episodes 21-27

Izzie And Denny Get Engaged And Denny Dies

When Izzie is assigned to Denny, there's an immediate connection between the two that makes her take a firm step away from Alex. Izzie and Denny have a ionate and whirlwind romance while he's stuck in the hospital that includes a proposal. Then, she cuts his LVAD wire to ensure he is given a heart quickly. Izzie's actions would have gotten someone fired from her position in the real world, but Izzie isn't fired, which is one of the most confusing Izzie plotlines on Grey's Anatomy as well as one of the darkest and most emotional.

Izzie risks her career for Denny and is devastated when he es away from a stroke in season 2, episode 27, "Losing My Religion." Throughout the episode, the chief interrogates the interns, wanting to learn who really cut the wire, but it's not until after Denny dies that Izzie confesses. She feels like nothing else matters, and she quits her job (though it's not permanent) to save the chief from having to punish her.

Season 3, Episode 1-Season 4, Episode 17

Izzie And Alex Are In Other Relationships

Alex and Izzie remain broken up in seasons 3 and 4 of Grey's Anatomy as they develop feelings for other people. These separate relationships allow Izzie and Alex to grow as characters while they're apart from one another, allowing them to be more than simply a romantic pairing in the series.

In season 3, Izzie and George begin seeing each other, which is problematic since he is married to Callie Torres (Sara Ramirez). The relationship is a surprise for a lot of fans at the time since they hadn't had romantic leanings toward one another in the past. Alex falls in love with Rebecca Pope (Elizabeth Reaser), who is called Ava at first, and helps her come to with her accident, not ing anything about her life, and her tough relationship with her husband Jeff (Jason London). Both Alex and Izzie become vulnerable with these other people, but something is missing, which eventually leads them back to each other.

Season 5, Episodes 1-6

Alex And Izzie Get Back Together And Alex Wonders If They Are Truly Committed

While Izzie and Denny are one of the best Grey's Anatomy couples due to their strong feelings for each other, Izzie genuinely cares about Alex as well, and the characters reunite at the beginning of season 5. They've had some distance from one another and been able to grow so that they can have a more meaningful relationship. They've both suffered heartbreak due to their experiences with Ava and Denny, and they've both come out the other side.

Izzie and Alex miss each other, and it's clear that the bond that they formed back in season 1 when discussing that they both had unstable homes and uncaring parents is still intact. When Alex asks if they are dating other people or just each other, this is a catalyst for their wedding, which allows them to finally commit.