Abstract Background An increasing number of women are pursuing a career in surgery. Concurrently, the percentage of surgeons in dual-profession partnerships is increasing. We sought to evaluate the ...gender differences in professional advancement, work-life balance, and satisfaction at a large academic center. Materials and methods All surgical trainees and faculty at a single academic medical center were surveyed. Collected variables included gender, academic rank, marital status, family size, division of household responsibilities, and career satisfaction. Student t -test, Fisher's exact test, and chi-square test were used to compare results. Results There were 127 faculty and 116 trainee respondents (>80% response rate). Respondents were mostly male (77% of faculty, 58% of trainees). Women were more likely than men to be married to a professional (90% versus 37%, for faculty; 82% versus 41% for trainees, P < 0.001 for both) who was working full time ( P < 0.001) and were less likely to be on tenure track ( P = 0.002). Women faculty were more likely to be primarily responsible for childcare planning ( P < 0.001), meal planning ( P < 0.001), grocery shopping ( P < 0.001), and vacation planning ( P = 0.003). Gender-neutral responsibilities included financial planning ( P = 0.04) and monthly bill payment ( P = 0.03). Gender differences in division of household responsibilities were similar in surgical trainees except for childcare planning, which was a shared responsibility. Conclusions Women surgeons are more likely to be partnered with a full-time working spouse and to be primarily responsible for managing their households. Additional consideration for improvement in recruitment and retention strategies for surgeons might address barriers to equalizing these gender disparities.