Following in the footsteps of cardiovascular researchers and clinicians, the pulmonary scientific community is beginning to explore how gender may impact the diagnosis, treatment, and surveillance of chronic obstructive pulmonary disease (COPD). Investigators and clinicians in this field are tackling the complex questions surrounding how differences in male/female biology may interact with gender differences in environmental, societal, cultural, and behavioral determinants of health to influence outcomes in COPD. In this article, issues such as gender differences in symptoms, gender diagnostic bias, differential impact of therapies, including smoking cessation and pharmacologic management, as well as the impact of these issues on COPD surveillance, are discussed. Current knowledge from the literature coupled with discussions from a 1-day symposium on gender and COPD diagnosis, management, and surveillance are detailed, including recommendations on where future research endeavors may be targeted.