Women remain underrepresented in general surgery residency leadership, limiting equity in surgical practice.

• In 363 programs, only 33.4% of leaders are women, with men dominating all leadership roles except assistant professors.
• Men have more years of practice and higher scholarly output, though this difference disappears when accounting for career length.

Improving promotion paths and leadership selection could help balance gender representation.

• Disparity is most pronounced at the department chair level, suggesting systemic barriers in academic advancement.