Aim As little is known about alcohol and tobacco consumption concordance between older spouses in low‐ and middle‐income countries, the present study aimed to estimate this in older couples from five Latin American countries. Methods This study is a secondary analysis of data collected between 2003 and 2007 by the 10/66 Dementia Research Group, from 1451 couples aged over 65 years from Cuba, the Dominican Republic, Peru, Mexico and Puerto Rico. Kappa statistic was used to assess the agreement of the behavior beyond chance, and logistic regression models with meta‐analyses were used to estimate the factors associated with concordance. Results The mean age of the total sample was 74.8 years (SD 6.6). The results showed high levels of agreement rates in relation to drinking and smoking (75.9% and 85% of couples, respectively, did not drink or smoke), which were beyond the agreement expected by chance. Increased age was associated with concordance on both being non‐drinkers (OR 1.03, 95% CI 1.01–1.05) and non‐smokers (OR 1.05, 95% CI 1.02–1.07); and having a larger social network was associated with less likelihood of the couple being non‐drinkers (OR 0.93, 95% CI 0.88–0.98). Attending religious meetings was associated with increased likelihood of the couple being non‐smokers (OR 1.19, 95% CI 1.01–1.41). Socioeconomic circumstances were not associated with couples’ concordance. Conclusions Older Latin American couples have high levels of concordance in drinking and smoking habits, which increases with age, and were not associated with socioeconomic circumstances, but were with social network. This knowledge can assist the development of policies and interventions to promote health among this growing population. Geriatr Gerontol Int 2017; ••: ••–••.