This study employs Heideggerian hermeneutic phenomenology to uncover the existential meaning of couples' long-term experiences of living with stroke. Transcripts of 23 interviews with stroke survivors and 17 interviews with spouses focusing on the couple perspective were analyzed. The five emerging themes and the constitutive pattern illuminate the existential meaning of stroke and include fear, hope, unfamiliarity, temporality, and reinterpretation of the life-world. The constitutive pattern indicates that life after stroke is characterized by the struggle to adapt to an abruptly twisted and unfamiliar being-in-the-world. Changes in couples' interpretations of their life-world seem to be connected with different interpretations of time and an increased view of life as limited. Health professionals with an empathic understanding of the existential meaning of stroke may better facilitate the reinterpretation of couples' actual life-world. Stroke couples' life-restricting fears of living, dying, and caregiving should be explored further.