Studies in mice indicate gender-specific differences in surgical complications with a distinct advantage for females. In patient care, however, gender has been an underrated aspect of complication management in abdominal surgery as far. Proven differences between the sexes regarding anatomy, hormonal regulation, constitutional polymorphisms, immune response and psychology suggest different types and incidence of complications and seem to justify studies on the topic. This review aims to compare a selection of current original articles reporting on complications following abdominal surgery separately for the genders. However, data in the literature are sparse and in part very heterogeneous. With data on colorectal carcinoma being most comprehensive, for stomach, oesophagus and finally pancreas fewer data can be found. Summing up all organ systems, the following cautious conclusions can be drawn. Men tend to suffer from postoperative complications more frequently. Men have more cases of anastomotic leakage, whereas women suffer from anastomotic stenosis more often. Currently, however, existing data do not justify any adaptation of patient management. Thus, taking gender aspects into account in designing new trials is paramount in order to obtain robust gender-specific data on incidence and types of complications.