Objective To explore the mediating effect of dual coping between care burden and negative emotions in spouses of stroke patients with hemiplegia, so as to provide a reference for improving spouses′ physical and mental health. Methods A total of 311 spouses of stroke patients with hemiplegia were selected by using convenience sampling method, then they were investigated by utilizing a general information questionnaire, the Zarit Caregiver Burden Interview (ZBI), the Dyadic Coping Inventory (DCI), the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS). Results The participants′ score of ZBI was (59.49±13.90), DCI was (86.03±16.62), SAS was (54.75±6.14), and SDS was (49.73±7.93). Dyadic coping played partial mediating effects between spouse care burden and anxiety and depression, and the mediating effect accounted for 50.21% and 47.27% of the total effect, respectively. Conclusion Dyadic coping is a mediating variable between care burden and negative emotions in spouses of stroke patients with hemiplegia. Medical staff should try to construct a dual coping intervention program to improve the dual coping level of spouses of hemiplegic stroke patients, reduce their care burden, and improve their negative emotions.