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The petitioners were fourteen same-sex couples and two men whose same-sex partners were deceased. They lived in Michigan, Kentucky, Ohio, and Tennessee. Those states defined marriage as a union between one man and one woman under their constitutions and statutes. The petitioners filed suits in federal district courts in their home states. They sought marriage licenses or recognition of marriages lawfully performed elsewhere. James Obergefell and John Arthur traveled from Ohio to Maryland to marry aboard a medical transport plane because Arthur suffered from ALS; Obergefell later sought to be listed as surviving spouse on Arthur's death certificate. April DeBoer and Jayne Rowse, Michigan nurses, adopted three children but could not both serve as legal parents under state adoption rules. Army Reserve Sergeant Ijpe DeKoe and Thomas Kostura married in New York before DeKoe's deployment to Afghanistan and later settled in Tennessee. Each district court ruled in the petitioners' favor. The respondents appealed. The Sixth Circuit consolidated the cases and reversed the district court judgments. The petitioners sought certiorari, which the Supreme Court granted. Same-sex couples had begun establishing families after substantial cultural and political developments in the late twentieth century. Earlier litigation had addressed the legal status of gays and lesbians, including challenges that reached the Supreme Court in Bowers v. Hardwick and Lawrence v. Texas.

Hosanna-Tabor Evangelical Lutheran Church and School is a member congregation of the Lutheran Church-Missouri Synod and operates a school in Redford, Michigan, offering a Christ-centered education to students in kindergarten through eighth grade. The Synod classifies its schoolteachers into two categories: called and lay. Called teachers are regarded as having been called to their vocation by God through a congregation and must complete academic requirements, including a colloquy program requiring eight courses of theological study, endorsement by the local Synod district, and passage of an oral examination by a faculty committee before receiving the formal title Minister of Religion, Commissioned. Lay teachers are not required to be trained by the Synod or even to be Lutheran. Lay teachers are hired only when called teachers are unavailable. Cheryl Perich was first employed by Hosanna-Tabor as a lay teacher in 1999. After Perich completed her colloquy later that school year, Hosanna-Tabor asked her to become a called teacher. Perich accepted the call and received a diploma of vocation according her the title Minister of Religion, Commissioned. Perich taught kindergarten during her first four years and fourth grade during the 2003-2004 school year, covering math, language arts, social studies, science, gym, art, and music. She also taught a religion class four days a week, led the students in prayer and devotional exercises each day, and attended a weekly school-wide chapel service, leading the service herself about twice a year. Perich became ill in June 2004 with what was eventually diagnosed as narcolepsy. Perich began the 2004-2005 school year on disability leave. On January 27, 2005, Perich notified the school principal that she would be able to report to work the following month. The principal responded that the school had already contracted with a lay teacher to fill Perich's position for the remainder of the school year. On January 30 the congregation voted to offer Perich a peaceful release from her call, whereby the congregation would pay a portion of her health insurance premiums in exchange for her resignation as a called teacher. Perich refused to resign and produced a note from her doctor stating that she would be able to return to work on February 22. On the morning of February 22 Perich presented herself at the school and refused to leave until she obtained written documentation that she had reported to work. Later that afternoon the principal called Perich at home and told her that she would likely be fired. Perich responded that she had spoken with an attorney and intended to assert her legal rights. Following a school board meeting that evening, board chairman Scott Salo sent Perich a letter stating that Hosanna-Tabor was reviewing the process for rescinding her call. Salo subsequently followed up with a letter advising Perich that the congregation would consider whether to rescind her call at its next meeting. As grounds for termination, the letter cited Perich's insubordination and disruptive behavior on February 22 as well as the damage she had done to her working relationship with the school by threatening to take legal action. The congregation voted to rescind Perich's call on April 10, and Hosanna-Tabor sent her a letter of termination the next day. Perich filed a charge with the Equal Employment Opportunity Commission alleging that her employment had been terminated in violation of the Americans with Disabilities Act. The EEOC brought suit against Hosanna-Tabor alleging that Perich had been fired in retaliation for threatening to file an ADA lawsuit. Perich intervened in the litigation. The District Court granted summary judgment for Hosanna-Tabor. The Sixth Circuit vacated and remanded. The Supreme Court granted certiorari.

In 2012 and 2013, three closely held for-profit corporations—Hobby Lobby Stores, Inc., Mardel, Inc., and Conestoga Wood Specialties Corp.—along with their owners, the Green and Hahn families, filed suits against the Secretary of Health and Human Services and other federal officials. Hobby Lobby operates over 500 stores with more than 13,000 employees. Mardel runs 35 Christian bookstores with nearly 400 employees. Conestoga employs about 950 people in its woodworking business. The Green family owns and operates Hobby Lobby and Mardel. The Hahn family owns and operates Conestoga. Both families hold sincere Christian religious beliefs that life begins at conception. Under the Patient Protection and Affordable Care Act of 2010, employers with 50 or more full-time employees must provide group health insurance covering certain preventive services for women, including 20 FDA-approved contraceptive methods, without cost sharing. The Department of Health and Human Services issued regulations requiring coverage of all 20 methods. The Greens and Hahns object specifically to four methods because they believe these may prevent implantation of a fertilized egg, which they view as destroying an embryo in violation of their faith. If the companies fail to provide the required coverage, they face penalties of $100 per day per affected employee, potentially reaching $475 million annually for Hobby Lobby, $33 million for Conestoga, and $15 million for Mardel. Alternatively, dropping coverage entirely could trigger penalties of $2,000 per employee per year. The companies and owners sued under the Religious Freedom Restoration Act of 1993, seeking to enjoin the mandate as applied to the four objected-to methods. The District Court for the Western District of Oklahoma denied a preliminary injunction to the Greens and their companies. The Tenth Circuit reversed, holding that the corporations could assert RFRA claims. In the Eastern District of Pennsylvania, the District Court denied a preliminary injunction to the Hahns and Conestoga. The Third Circuit affirmed, concluding that for-profit corporations cannot exercise religion under RFRA. The Supreme Court granted certiorari and consolidated the cases.

On the night of January 11, 1983, Nancy Beth Cruzan lost control of her car as she traveled down Elm Road in Jasper County, Missouri. The vehicle overturned, and Cruzan was discovered lying face down in a ditch without detectable respiratory or cardiac function. Paramedics were able to restore her breathing and heartbeat at the accident site, and she was transported to a hospital in an unconscious state. An attending neurosurgeon diagnosed her as having sustained probable cerebral contusions compounded by significant anoxia. The Missouri trial court found that permanent brain damage generally results after six minutes in an anoxic state, and it was estimated that Cruzan was deprived of oxygen from twelve to fourteen minutes. She remained in a coma for approximately three weeks and then progressed to an unconscious state in which she was able to orally ingest some nutrition. Surgeons implanted a gastrostomy feeding and hydration tube in Cruzan with the consent of her then husband. Subsequent rehabilitative efforts proved unavailing. She now lies in a Missouri state hospital in what is commonly referred to as a persistent vegetative state in which a person exhibits motor reflexes but evinces no indications of significant cognitive function. The State of Missouri is bearing the cost of her care. After it had become apparent that Nancy Cruzan had virtually no chance of regaining her mental faculties, her parents Lester and Joyce Cruzan, who serve as coguardians, asked hospital employees to terminate the artificial nutrition and hydration procedures. All agree that such a removal would cause her death. The employees refused to honor the request without court approval. The parents then sought and received authorization from the state trial court for termination. The trial court found that a person in Nancy's condition had a fundamental right under the State and Federal Constitutions to refuse or direct the withdrawal of death prolonging procedures. The court also found that Nancy's expressed thoughts at age twenty-five in conversation with a housemate friend suggested that given her present condition she would not wish to continue on with her nutrition and hydration. The Supreme Court of Missouri reversed by a divided vote. The court recognized a right to refuse treatment embodied in the common-law doctrine of informed consent but expressed skepticism about the application of that doctrine in the circumstances of this case. The court found that Cruzan's statements to her roommate regarding her desire to live or die under those conditions were unreliable for determining her intent and thus insufficient to support the coguardians' claim to exercise substituted judgment on Nancy's behalf. It rejected the argument that Cruzan's parents were entitled to order the termination of her medical treatment, concluding that no person can assume that choice for an incompetent in the absence of the formalities required under Missouri's Living Will statutes or the clear and convincing inherently reliable evidence absent here. The Supreme Court granted certiorari to consider the question whether Cruzan has a right under the United States Constitution which would require the hospital to withdraw life-sustaining treatment from her under these circumstances.