Alex Karev, played by Justin Chambers, left Grey's Anatomy because Justin Chambers decided to leave the show to diversify his acting roles and career choices after 15 years on the series. His final appearance was in Season 16, and his departure was explained through letters he sent to key characters like Jo, Meredith, and Bailey. Alex left Seattle abruptly to reunite with his ex- wife Izzie Stevens, who had used embryos they had frozen years ago to have twins. He chose to stay with Izzie and his children in Kansas to ensure they wouldn't grow up without a father, which aligned with his own difficult childhood. However, many fans found this exit controversial and felt it negated much of Alex's character development, especially because he left his then-wife Jo without a proper onscreen explanation or goodbye. The actor did not film an on-camera farewell, only providing a voiceover for the goodbye episode, and the storyline was divisive among viewers. In summary, Justin Chambers left to pursue other acting opportunities, and the show wrote Alex Karev’s exit by having him go to Kansas to be with Izzie and their twins, which stirred controversy among fans due to the nature of his departure and impact on ongoing characters.