The authors present the results of a 15-year review of research on the effects of pornography on couple relationships, including intimacy. This review includes 26 empirically-based studies that were conducted between 2000 and 2016. This research topic has mostly been approached from an exploratory and descriptive perspective. Criticisms of the literature center on the lack of attention paid to the theoretical level of analysis and the unit of observation. The difficulty researchers have with defining “pornography” affects the measures used to assess pornography’s effects on couple relationships and limits the external validity of results. Findings indicate that there are both positive and negative effects of pornography use within committed relationships. These effects appear to be mediated largely by communication between both partners. Research with attention to a consistent theoretical level of analysis and unit of observation is needed to more fully understand the impact of pornography use on a couple’s relationship. Recommendations for future research are provided.