Understanding couples’ relationship problems is fundamental to couple therapy. Although research has documented common relationship problems, no study has used open-ended questions to explore problems in couples seeking therapy in naturalistic settings. The present study used a reliable coding system to explore the relationship problems reported by 108 couples. The most common problems were related to communication, emotional affection or distance, specific areas of the current relationship, and lack of physical affection or sex. Comparisons of therapeutic mandates revealed that commitment or security problems and infidelity or flirting problems were more common among couples pursuing an ambivalence resolution mandate than among couples pursuing an alleviation of distress mandate. Results demonstrated the importance of identifying distinct therapeutic mandates in couple therapy.