At his wife's suggestion in 1969, the Spanish State gave her husband he title Prince of Spain as he was the heir to the throne. At his father's death in 1975, her husband ascended the throne as King Juan Carlos I.
Together, they have three children, a daughter-in-law and a son-in-law, and eight grandchildren. They are:
- Infanta Elena, Duchess of Lugo (1963)
- Don Felipe Juan Froilán de Todos los Santos de Marichalar y Borbón (1998)
- Doña Victoria Federica de Todos los Santos de Marichalar y de Borbón (2000)
- Infanta Cristina, Duchess of Palma de Mallorca (Iñaki Urdangarín, Duke of Palma de Mallorca)
- Don Juan Valentín de Todos los Santos Urdangarín y de Borbón (1999)
- Don Pablo Nicolás Sebastián de Todos los Santos Urdangarín y de Borbón (2000)
- Don Miguel de Todos los Santos Urdangarín y de Borbón (2002)
- Doña Irene de Todos los Santos Urdangarín y de Borbón (2005)
- Prince Felipe of Austrias (1969) (Princess Letiza of Austrias)
- Infanta Leonor (2005) (who is also their goddaughter)
- Infanta Sofia (named in her grandmother's honor)
Even though in recent years their daughters have been in the media for the turmoil of marriages (Elena divorced her husband in 2009, and Cristina's husband has recently been caught in a scandal and banned from royal activities because of it), and their son waited until he was a little older to marry (he was 36 years old when he married), the King and Queen have kept it together for 50 years-since she was 23 years old and he was 24 years old.