In 1999, Ruehl married painter David Geiser with whom she had adopted a son, Jake (born 1995). She had another son, Christopher, whom she gave up for adoption in 1976 when she was 28. They were reunited in the late 1990s when he turned 21, and later Christopher became Jake's godfather. Ruehl and Geiser put their Hampton house on the market in 2017; the same year Ruehl was quoted as saying that they were no longer together, but remained close. David Geiser died unexpectedly of heart disease in his sleep at home on October 14, 2020 at the age of 73.