The episode focuses on Jo Wilson (Camilla Luddington) grappling with the uncertainty of her relationship with Alex Karev (Justin Chambers) after discovering a possible connection to his former partner, Izzie Stevens (Katherine Heigl), leading her to confide in her close friend, Stephanie Edwards (Jerrika Hinton).

Meanwhile, Maggie Pierce (Kelly McCreary) reconsiders her life choices after receiving an invitation to her ex-boyfriend Ethan Boyd's (Lance Gross) wedding, and Richard Webber (James Pickens Jr.) questions Chief Miranda Bailey's (Chandra Wilson) loyalty.

Meredith carpools to work with her half-sister, Maggie Pierce (Kelly McCreary), and her sister-in-law, Amelia Shepherd (Caterina Scorsone), but expresses annoyance over both Amelia's nakedness while changing in the car, stating her children sit in that seat, and Maggie's denial about the wide-eyed expression she makes upon reading a notice for Meredith's promotion to Head of General Surgery following Miranda Bailey's (Chandra Wilson) promotion to Chief of Surgery.

Richard Webber (James Pickens Jr.) overhears Callie Torres (Sara Ramirez) inform Meredith that she has been underpaid regarding her new salary as Head of General Surgery.

Maggie expresses apprehension about an invitation to her ex-boyfriend, Ethan Boyd (Lance Gross)'s wedding, culminating in her kissing Andrew DeLuca (Giacomo Gianniotti) at Joe's bar.

When Alex comes home after staying up all night to make contacts for a donor for the less healthy twin, Jo confronts him with an invoice from the fertility clinic about his embryos with Izzie Stevens (Katherine Heigl) 7 years prior.

Meanwhile, Jackson Avery (Jesse Williams) expresses frustrations with April Kepner (Sarah Drew), who has returned from the army, stating he is changing the locks and wants a divorce.

[3] "I Choose You" received positive reviews television critics, with high praise directed towards Justin Chambers' portrayal of Alex Karev and his long-term character development throughout the series.

"[6] For Cosmopolitan, Lauren Hoffman commented on April Kepner's (Sarah Drew) "creepy" behavior and referenced a Fatal Attraction joke made by (Jackson Avery) Jesse Williams.

TVLine's Andy Patrick pointed out how the episode subverted expectations by misleading viewers into thinking Jo was pregnant, only to reveal she had found Izzie's embryos.

Hoffman also praised the episode as "belonging to Alex Karev" and lauded his transformation from "a smartass kid from an abusive household in Iowa" into a "mature, whip-smart surgeon."