Families engage in strategic topic avoidance about a range of health topics, from serious illnesses such as cancer to mental health, to risky behaviors related to sexual health and substance use. Most of this research has examined topic avoidance in couples, parent–child relationships, and family caregiving contexts, with emerging focus on siblings and broader family systems. Family members are motivated to avoid difficult or potentially conflict‐inducing topics related to health, such as distressing emotions, death and dying, and identity‐threatening issues like body image and past risky behavior. Family members report avoiding topics in order to accomplish numerous goals, such as protecting one another from distressing emotions and respecting one another's privacy. Some health topics are avoided by families because of their complex and uncertain nature, which leaves families feeling unable to discuss them adequately. Although many people perceive benefits from avoiding tough conversations about health with family members, there is also evidence that avoidance is associated with lower relationship satisfaction and mental well‐being.