In the Season 8 episode "My Cuz," J.D. left Sacred Heart to move closer to his son. Though Elliot remained at Sacred Heart, she moves in with J.D., despite the long commute. Before J.D. left the hospital for good, he had a prolonged fantasy (implied to be a flash-forward) that showed him and Elliot getting married and having at least one child together. By the start of Season 9, set a year after the Season 8 finale, they were married and expecting their first child--a daughter.