Objective To explore the influence of conjugal empathy on self disclosure and intimate relationship in young breast cancer patients and spouses based on the Actor-partner Interdependence Model (APIM). Methods A total of 281 young breast cancer patients and their spouses were investigated by using a general information questionnaire, Interpersonal Reactivity Index-C (IRI-C), Distress Disclosure Index (DDI) and Marriage Adjustment Test (MAT). Paired data were processed with APIM. Results The patients′ total scores of IRI-C and DDI were significantly higher than those of their spouses (P<0.05 for both), while it was not significantly different in the score of MAT between them (P>0.05). APIM results showed that, the patients′ and their spouses′ IRI-C score could significantly and positively predict their own score of DDI and MAT, and the patients′ IRI-C score could significantly and positively predict their spouses′ MAT score (P<0.05), but could not predict the spouses′ DDI score (P>0.05), and the spouses′ IRI-C score could significantly and positively predict the patients′ score of DDI and MAT (P<0.05 for both). The results of path analysis indicated that, the spouses′ empathy could affect the patients′ intimate relationship through their self disclosure (P<0.05). Conclusion The empathy of young breast cancer patients and their spouses are at medium and above level, which influence their own and spouses′ self disclosure and intimate relationship. It is necessary to develop interventions based on binary empathy perspective of wife and husband, to enhance their empathy ability,then improve self disclosure and intimate relationship of patients and spouses.