The incidence of stroke in women is growing and now has become a public health issue (Lancet Neurol 2008, 7:915-926). Women have an expectation of life at birth greater than man and they have a higher mortality for stroke in the age groups increased, for these two reasons the stroke occurs more in women than in men (Heart Disease and Stroke Statistics 2007 Update Dallas Tex. 2007). This gender difference is set to grow in coming decades. Women have a worse disability than men (Stroke 2003, 34:1114-1119; Stroke 2007, 38:2541-2548). At the time of stroke women are 4-5 years older on average than men and this difference could impact in acute management of stroke (Stroke 2003, 34:1114-1119; Stroke 2005, 36:809-814; Stroke 2008, 39:24-29; Neurology 2005, 65:855-858). The objective of this work is to examine gender differences in the quality of care in GWTG (Get With The Guidelines-Stroke) (Arch Intern Med 2008; 168:411-417; Circulation 2009; 119:107-115). 383,318 hospitalizations for acute ischemic stroke from 1139 hospitals participating in GWTG between 2003 and 2008 were analyzed. 52.6% of hospitalizations was represented by women. The women were older (73.3 vs. 68.5), presented more often by ambulance (60.1% vs 56.8%) had a positive history for atrial fibrillation (20.4% vs 15.6%) and hypertension (76.5% vs 71.9%), but less often had a positive history for previous stroke (24% vs 32%), dyslipidemia (34.2% vs 38.1%) and smoking (15.2% vs 23.7%). In hospital, women had a higher mortality (6% vs 5.2%) and fewer were discharged at home (41% vs 49.5%). Women received less defect free care than men (66.3% vs 71.1%). Quality of care for women with ischemic stroke was lower than for men and women were less likely to be discharged home.