Talk about a lengthy dating history! Dr. Alex Karev is one of the few original Grey Sloan Memorial surgeons still on Grey’s Anatomy today, so it’s no surprise that bad boy Alex has had quite a few girlfriends over the years. Today, “Dr. Hottie” is finally happy with on-and-off love, Dr. Jo Wilson — but it has taken Alex quite a long relationship journey to get here. Scoll down to meet all of Alex’s girlfriends!

Jo Wilson

Jo and Alex first hit it off at Miranda Bailey‘s wedding in Season 9. Alex later admitted he loved Jo and the two began dating. One season later, Alex proposed at April Kepner’s wedding but Jo declined and the two simply continued dating with the assumption that they’d one day tie the knot. After two years, Alex popped the question again, and Jo took ages to give him an answer. The two eventually split but soon after got back together. Jo later told her co-worker Andrew DeLuca that she couldn’t marry Alex because she was still married to her abusive husband and was now living under a new identity.

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Alex and Jo on Grey’s Anatomy. (Photo Credit: Getty Images)

During Jo’s confession, Alex walked in on DeLuca trying to get a drunken Jo to bed and he assumed the two were sleeping together. He then badly beat up DeLuca, further putting a strain on his romance with Jo. At the start of Season 14, Alex revealed to Jo that he had found her husband but hadn’t killed him (though he wanted to), proving that he wasn’t an inherently violent person. Jo finally took him back and the two are happily — at least for now! — dating again during the current Grey’s season. What a rollercoaster, right?

Izzie Stevens

After years of working side-by-side as Seattle Grace surgical interns, Alex and Izzie began a romantic relationship that Alex soon ruined by sleeping with nurse Olivia Harper (see below for more on her!). The two later reconciled, but Izzie again dumped Alex after he referred to her patient Denny Duquette — who was suffering from heart failure — as a “corpse.” At the time, Izzie said, “Just so we’re clear, we’re over. On your very best day, that ‘corpse’ is twice the man you will ever be. You’re not good enough for me, Alex. You’re not good enough for anyone.”

When Denny later died, Alex helped Izzie cope with his death and realized his romantic feelings for her hadn’t gone away despite their breakup. Izzie was later diagnosed with cancer and she and Alex married in Season 5, but she subsequently left Alex after the death of her best friend George O’Malley. They eventually divorced and Izzie never returned to Seattle.

Rebecca Pope (Ava)

After rescuing a severely disfigured pregnant woman in a ferry accident, Alex helped care for the Jane Doe patient — eventually nicknamed “Ava” — at Seattle Grace as she recovered. As the two spent more time together in the hospital, they became attached and even began a romantic relationship. Months later, Ava learned her real identity was Rebecca Pope, a married mother-of-one, and returned home. But, Ava continued to visit Alex at the hospital and even told him she was pregnant with his baby.

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Alex and Izzie on Grey’s Anatomy. (Photo Credit: Getty Images)

Izzie later revealed that Ava wasn’t really pregnant and was just trying to get Alex to keep dating her. While staying with Alex at Meredith Grey‘s house, Ava slit her wrists in a suicide attempt and was then diagnosed with borderline personality disorder. After she was admitted to the hospital’s psych ward, Alex cut his ties with Ava once and for all.

Lexie Grey

After his marriage to Izzie fell apart, Alex began dating Meredith’s little sister Lexie. The two dated for a while, but when Alex was shot in the Season 6 hospital shooting, he cried out for Izzie instead of his girlfriend, Lexie, making her realize that he was still in love with his ex-wife. Alex and Lexie went their separate ways soon after.

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Alex and Ava on Grey’s Anatomy. (Photo Credit: Getty Images)

Lucy Fields

During Season 7, Alex had a brief relationship with Lucy, who was the new attending OB/GYN at Seattle Grace. Alex’s mentor Arizona Robbins later offered him an opportunity to work in Africa and Lucy was upset that he didn’t consider her opinion before telling Arizona he would go. Alex then decided not to go to Africa to keep dating Lucy instead, but she had secretly accepted the Africa position herself. The two obviously broke up and Lucy was never heard of again. Awkward!

Olivia Harper

Back in the early Grey’s days, Alex started sleeping with nurse Olivia but she later dumped him because she realized she had stronger feelings for Alex’s fellow intern George. Later in the series, Alex was caught cheating on Izzie with Olivia, but he and Izzie eventually got back together.

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