Objective To explore the trends and relationships between dyadic coping and depression over time in stroke patients and their spouses, and to provide a reference for the development of interventions. Methods From April 2021 to December 2021, 202 stroke patients and their spouses were conveniently selected and assessed by using the Dyadic Coping Inventory and the Patients Health Questionnaire-9 during the stable phase (T1), 1 month (T2) and 3 months (T3) after discharge.Then cross-lagged panel model was constructed to determine the relationship between dyadic coping and depression in the spousal dyads. Results The level of dyadic coping in the spousal dyads first increased and then decreased over time, whereas the depression symptom scores consistently decreased over time, and the trends of these two variables had significant time effects (all P＜0.05), but the gender differences were not significant.Cross-lagged panel analyses showed that there was an autoregressive effect on the dyadic coping and depression scores of the spousal dyads (namely, their own T1 scores significantly affected their own T2 scores, and their own T2 scores significantly affected their own T3 scores); patient′s and spouse′s dyadic coping cross-predicted each other′s dyadic coping;patient′s depression positively predicted spouse′s depression;spouse′s depression negatively predicted patient′s dyadic coping;patient′s and spouse′s dyadic coping predicted their own depression (all P＜0.05). Conclusion Level of dyadic coping and depression and incidence of depression were dynamically changing in stroke patients and their spouses.Dyadic coping and depression were causal and intertwined.Clinical and community healthcare professionals should focus on comprehensive family-centred intervention programs to improve the psychological state and coping ability of couples.