Interracial relationships are becoming increasingly common in the United States, yet the physical health status of individuals in interracial relationships is not well understood. Using 18 years of pooled data from the National Health Interview Study (2001-2018) (N = 264, 891), we compared the odds of having multiple chronic conditions (MCC) among adults in interracial and same-race unions. We anticipate that individuals in interracial relationships may be at higher risk of MCC than individuals in same-race relationships due to increased exposure to stressors associated with crossing racial boundaries. Findings indicate that the implications of interracial relationships on MCC depended on the racial composition of the couple. We found that White-Black couples had higher odds of MCC than both White-White and Black-Black couples, but Asian-Black and Hispanic-Black couples did not differ from their same-race couple counterparts, indicating a pronounced and unique health disadvantage for White adults paired with Black adults. We also found that Asian-White and Hispanic-White couples had higher odds of MCC relative to their same-race counterparts. In addition, minority-minority couples generally did not differ from their same-race minority couple counterparts in terms of MCC. The results of the study provide new insights into how the racial composition of interracial unions impacts health and how a closer proximity to Whiteness may be a health risk for some minority groups.