Media use may have the potential to influence romantic relationships, depending on the context of media use. For example, pathological media use, which includes symptoms of addiction such as relapse, withdrawal, and conflict with family and friends over media use, may be particularly damaging to romantic relationships. Additionally, research shows that pathological video game use can negatively influence factors of mental health, including depression. The current study includes 183 heterosexual couples from the Eastern United States. Both members of each couple completed online surveys answering questions regarding pathological media use, depression, and relationship satisfaction. Results showed that male pathological video game use was not associated with female romantic relationship satisfaction. Additionally, male pathological video game use was associated with increased levels of male depression, and male depression was associated with increased levels of female relationship satisfaction. However, male depression did not mediate the relation between male pathological video game use and female relationship satisfaction. Discussion focuses on the implications of pathological video game use on mental health, as well as problems within the sample, measurement, and short-term longitudinal study design.