Cox Arquette was born in Birmingham, Alabama to an affluent Southern family; her late father, Richard L. Cox, was a businessman and her mother, also named Courteney, was a housewife. Cox has two older sisters (Dottie Pickett and Virginia Cox), one older brother (Richard, Jr.) and nine half-brothers and half-sisters. Her parents divorced in 1974, and her father moved to Florida, while Cox grew up with her mother and her stepfather, New York businessman Hunter Copeland.

Cox was raised in an exclusive society town, Mountain Brook, Alabama. She attended Mountain Brook High School, where she was a cheerleader, tennis player and swimmer. Upon graduation, Cox went to study architecture and interior design at Mount Vernon College for Women. She dropped out after one year to pursue a modeling career, after being signed by the Ford modeling agency in New York City. While modeling, she also took acting classes, and lost her Southern accent.

Cox was the first person to use the word "period" on U.S. television in its physiological sense, in a 1985 advertising campaign for Tampax brand tampons. After coming to prominence in the 1984 music video for Bruce Springsteen's "Dancing in the Dark" (in which she became the pulled-on-stage-girl who danced onstage with Springsteen), she appeared in several theatrical films, including Masters of the Universe (1987) and Cocoon: The Return (1988).

Cox had a starring role in the short-lived television series, Misfits of Science (1985) and later had a recurring role (1987 - 1989) on the television series Family Ties.

Cox is best known for playing Monica Geller on the hit TV series Friends (1994 - 2004). She became the only principal member of the show's cast not to be nominated for an Emmy Award. After the show became successful, Cox appeared in several high-profile Hollywood films, including Ace Ventura: Pet Detective (1994), Scream (1996), Scream 2 (1997), and Scream 3 (2000), and also appeared in an episode of WCW Monday Nitro trying to convince her husband David Arquette that he was not a wrestler after Arquette had recently won the World Heavyweight Championship.

In late 2003, Cox hosted her own television series, entitled Mix It Up. It was taped at her home and focused on dealing with a partner moving in and interior decoration. The show received low ratings and was not renewed for a second season.

In 2005, Cox starred in the independent film November, which had only a limited theatrical release, and appeared in the big budget remake of The Longest Yard, although she was uncredited. She has signed on to star in Dirt, a television drama for the FX Networks, in which she will play Lucy Spiller, a tabloid editor; Cox and her husband, David Arquette, will executive produce the series.

Courtney Cox has dated agent Ian Copeland, singer Adam Duritz, and actor Michael Keaton. She met actor David Arquette on the set of Scream; the couple married on June 12, 1999 in an Episcopalian ceremony. While Cox has occasionally used her full married name, "Courteney Cox Arquette", professionally, she continues to be generally known simply as "Courteney Cox". On June 13, 2004, she gave birth to their first child, Coco Riley Arquette, a baby girl; her "Friends" co-star, Jennifer Aniston, is the baby's godmother. Reportedly, Cox initially wanted to name their child "Courteney," just as Cox herself was named after her mother; however, Arquette resisted this idea because his Jewish faith discourages naming children after living relatives. As a compromise, they agreed upon the name Coco, which was a nickname for Cox's mother.

In 1999, Cox underwent laser eye surgery to correct her vision, which was at "20/40".