Purpose: this study was to develop and test the structural model that explains husband and wife compatibility and family health of married middle-aged. A hypothetical model explaining husband and wife compatibility and family health based on literature reviews. There were three theoretical variables and twelve observed variables in hypothetical model. Methods: Data collection was carried out May through July 2005. Data were collected by self-reporting questionnaires from 854 married middle-aged who lived in Seoul, Busan, Daegu, Kyungnam, Kyungpook. Collected data was analyzed using SPSS/WIN 12.0 for descriptive statistics, Pearson Correlation coefficient, and Kolmogorov-Smirnov analysis. Results: LISREL program was used to find the best fit normal which assumes causal relationship among variables. This model was to be good fitting and parsimonious to measure husband and wife compatibility and family health of married middle-aged. Conclusion: Differentiation of self and husband and wife compatibility predicted level of family health. Therefore, a family health improvement program needs to include these two variables.