The gender landscape is changing as it relates to women being represented in medicine. Greater than 50% of medical school students are female but the distribution of women leaders fails to follow a similar trajectory. Women are outnumbered by men in leadership roles, but there is a trend towards increasing diversity within organizations to enhance organizational efficiency, increase revenue and promote innovation. Educational differences do not explain the paucity of women in leadership roles since women tend to achieve advanced degrees at the same degree or more than men. Glass ceiling effects, work-life balance concerns and lack of development programs targeting women have been identified as factors contributing to this disparity. Another factor is the perception of women as effective leaders which can contribute to their advancement and the ability of followers to be guided by them. Furthermore, systems of oppression in our society intersect to unfairly influence the perception of women as leaders. Similar to other surgical specialties, women in Otolaryngology-Head and Neck Surgery are under-represented in departmental and senior leadership positions. It is crucial for our members to understand these differences to better support the advancement of women into leadership roles, and enhance diversity within institutions and professional organizations.