This chapter will explore the emerging therapeutic field of neurodiverse couples counseling, in which one or both partners are on the autism spectrum. While the constellation of symptoms that comprise Autism Spectrum Disorder (ASD) vary for each person, there are hallmark challenges that arise within neurodiverse relationships. This chapter will address ways to identify neurodevelopmental differences and explore the core challenges in these partnerships, including communication, past experiences, and intimacy. It will offer practical strategies for discussing neurodiversity and therapeutically supporting couples in developing and maintaining healthy relationships.