More than one in five women die from ischemic heart disease (IHD) and given their longer life expectancy, these numbers are expected to rise and so is the concomitant disability burden. Women are still under-represented in cardiovascular research with much of the knowledge from clinical trials conducted largely with men being applied to women, disregarding potential gender differences in both biomedical and psychosocial domains. Gender differences in both pathophysiology and biological risk factors may underlie distinct prevalence rates, symptom profiles and even medical outcomes. Not only do women have more persistent and atypical symptoms, but have more frequent hospitalizations, lower rates of general well-being and increased functional limitations in daily life activities. Gender related specificities regarding psychosocial risk factors might further explain this. The authors review the key issues on this topic and outline suggestions for future research. Ultimately, a better understanding of this matter will translate not only into improved clinical management of female patients but also genderspecific strategies in the prevention of CVD.