PURPOSE: This study utilized a group-based dual-trajectory model to identify distinct dyadic quality of life (QoL) trajectories among young to middle-aged stroke couples and to analyze the predictive factors influencing these trajectories. METHODS: A longitudinal study was conducted with 168 young to middle-aged stroke couples. Assessments at baseline and at 1, 3, and 6 months post-discharge included patients' functional recovery (modified Rankin Scale) and stroke couples' depression, anxiety, stress, benefit finding, social support, couple relationship, and QoL (12-item short-form health scale). Dyadic QoL trajectories were identified using a group-based dual-trajectory model. Stepwise logistic regression was employed to identify the predictors of the trajectory groups. RESULTS: Three subgroups of dyadic physical QoL trajectories were distinguished: "patients low increase-spouses moderate physical QoL" (15.4%), "patients moderate increase-spouses moderate physical QoL" (74.0%), and "patients moderate increase-spouses high physical QoL" (10.6%). Two subgroups of dyadic mental QoL trajectories were distinguished: "dyadic low increase mental QoL" (15.9%), and "dyadic high increase mental QoL" (84.1%). The trajectory groups were influenced by the patient's sex, functional recovery, depression, and the spouse's mutuality. CONCLUSIONS: The group-based dual-trajectory model facilitates the identification of distinct dyadic QoL trajectories among stroke couples. These findings provide valuable insights for developing targeted interventions aimed at improving their QoL.