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On the return from the campaign, Lucius was awarded with a triumph; the parade was unusual because it included the two emperors, their sons and unmarried daughters as a big family celebration. Marcus Aurelius' two sons, Commodus, five years old, and Annius Verus, three, were elevated to the status of Caesar for the occasion.

The returning army carried with them a plague, afterwards known as the Antonine Plague, or the Plague of Galen, which spread through the Roman Empire between 165 and 180. The disease was a pandemic believed to be either of smallpox or measles, and would ultimately claim the lives of two Roman emperors—Lucius Verus, who died in 169, and Marcus Aurelius, whose family name, Antoninus, was given to the epidemic. The disease broke out again nine years later, according to the Roman historian Dio Cassius, and caused up to 2,000 deaths a day at Rome, one-quarter of those infected. Total deaths have been estimated at five million.

Like many emperors, Marcus spent most of his time addressing matters of law such as petitions and hearing disputes;[246] but unlike many of his predecessors, he was already proficient in imperial administration when he assumed power.[247] Marcus took great care in the theory and practice of legislation. Professional jurists called him "an emperor most skilled in the law"[248] and "a most prudent and conscientiously just emperor".[249] He shows marked interest in three areas of the law: the manumission of slaves, the guardianship of orphans and minors, and the choice of city councillors (decuriones).[250] In 168 he revalued the denarius, increasing the silver purity from 79% to 82% — the actual silver weight increasing from 2.57 grams to 2.67 grams. However, two years later Marcus reverted to the previous values because of the military crises facing the empire.[145]

Marcus Aurelius acquired the reputation of a philosopher king within his lifetime

In the first two centuries of the Christian era, it was local Roman officials who were largely responsible for persecution of Christians. In the second century, the emperors treated Christianity as a local problem to be dealt with by their subordinates.[263] The number and severity of persecutions of Christians in various locations of the empire seemingly increased during the reign of Marcus Aurelius. The extent to which Marcus Aurelius himself directed, encouraged, or was aware of these persecutions is unclear and much debated by historians.[264]

While on campaign between 170 and 180, Aurelius wrote his Meditations in Greek as a source for his own guidance and self-improvement. The title of this work was added posthumously—originally he titled his work simply: "To Myself". He had a logical mind and his notes were representative of Stoic philosophy and spirituality. Meditations is still revered as a literary monument to a government of service and duty. The book has been a favourite of Frederick the Great, John Stuart Mill, Matthew Arnold, Goethe, Wen Jiabao, and Bill Clinton.[267]

Marcus Aurelius acquired the reputation of a philosopher king within his lifetime, and the title would remain his after death; both Dio and the biographer call him "the philosopher".[259] Christians—Justin Martyr, Athenagoras, Melito—gave him the title, too.[260] The last named went so far as to call Marcus "more philanthropic and philosophic" than Antoninus Pius and Hadrian, and set him against the persecuting emperors Domitian and Nero to make the contrast bolder.[261] "Alone of the emperors," wrote the historian Herodian, "he gave proof of his learning not by mere words or knowledge of philosophical doctrines but by his blameless character and temperate way of life."[262]

Iain King concludes Marcus Aurelius' legacy is tragic, because the emperor's "Stoic philosophy – which is about self-restraint, duty, and respect for others – was so abjectly abandoned by the imperial line he anointed on his death."[263]