Introduction: Females are underrepresented as speakers at major scientific conferences. Furthermore, in neurology, males outnumber females in academic positions, rank and number of publications, which may influence this inequality. Objective: To evaluate trends in invited speakers by sex at the International Stroke Conference (ISC). Methods: Data were obtained (years 2014-2018) for invited speakers to the ISC from the American Heart Association. Variables included sex, degree, race, speaker institution country, and speaker category. Data were analyzed by chi-square test, Fisher’s exact test, or logistic regression. Results: Over 5 years, 1086 individuals with 1283 presentations were invited for invited symposia (83%), pre-conference (11%), debate (5%), and case theater (1%). Females represented a mean of 29% of speakers, which did not vary by year (p=0.99), so years were combined. The highest and lowest proportions of females were in invited symposia (30.4%) and case theater (5.6%). All mid-levels and nurses, but only 17.7% of physician speakers were female. Females were 32.7% of Caucasian speakers and only 16.7% and 12.0% of Black and Hispanic speakers, respectively. The highest and lowest proportions of female speakers were from institutions in South America (50%) and Africa (0%). The proportion of female speakers was highest in nursing (86.4%) and pediatric stroke (45.2%) and lowest in neurocritical care and aneurysm (0%). Grouped, the highest proportion of female speakers was in recovery and rehabilitation (33.5%), and the lowest was in acute care (19%). Males were more likely invited as speakers more than once (p=0.01). Conclusions: Females are less likely invited speakers to the ISC compared to males, especially in fields like critical care, with a smaller female pool. Moreover, females in underrepresented racial groups and female physicians are less often speakers. Increased efforts are warranted to improve sex differences among speakers at the ISC.