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Individuals confronting chronic medical conditions often face profound challenges to cherished life goals. The primary aim of this study was to examine the associations of goal adjustment with psychological adjustment in the context of infertility. At study entry (T1; n = 97) and 6 months later (T2; n = 47), women in fertility treatment completed measures of goal blockage, goal adjustment ability, and psychological adjustment. At T1, greater perceived and actual goal blockage were related to negative psychological adjustment. Ability to disengage from the goal of biological parenthood was associated with less infertility-specific thought intrusion, whereas engagement with other goals was related to fewer depressive symptoms and greater positive states of mind. Greater general goal engagement was protective against the negative relationships between low goal disengagement and the dependent variables …