In this perspective article, the authors focus on gender as it relates to pulmonary disease. The very real threat of smoking and lung cancer has been recognized, but gender-related issues in other conditions have not been emphasized. There are minor differences in bronchial responsiveness and breathing mechanics between men and women. The subconscious conversion disorder of vocal cord dyskinesis occurs predominantly in young adult women. Sleep apnea and sleep-disordered breathing have a prevalence of 4% in men and 2% in women, aged 30 to 60 years. Many of these women may go unrecognized or be labeled with chronic fatigue syndrome if a good history for sleep disorders is not obtained. Primary pulmonary hypertension is more common in women than men but only by 1.7 to 1.0 for all ages. With further review of the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) data, the correlation of pulmonary embolism to estrogen use, child-bearing, and an increased incidence of thrombophlebitis has not been as strong as previously reported. Diseases such as lymphangioleiomyomatosis and the catamenial syndromes of pneumothorax, pleural effusions, and/or hemoptysis are unique to women but often present as perplexing clinical problems. The premenstrual exacerbation of asthma has been reported with increasing frequency. As evidence-based medical literature accumulates, gender-related differences and similarities will be clarified by studies with both men and women as subjects.