Coronary artery disease remains a predominant cause of morbidity and mortality in women. Some studies indicate that there exists a degree of gender bias in the distribution of surgical therapy for coronary artery disease. Numerous studies have demonstrated that female patients have a higher operative mortality rate when undergoing coronary artery bypass surgery. The reasons for this appear to be many including an increased number of comorbid factors in female patients, instability at the time of surgery, and smaller coronary artery size resulting in more technical difficulties and greater risk of incomplete revascularization. Once past the perioperative time period, however, female patients have survival and functional benefits from surgery equivalent to those of men. Increased awareness of clinical manifestations of coronary artery disease in women and careful selection of patients for surgical therapy is warranted.