<h3>Objectives:</h3> Employment disruption in the gynecologic cancer population may be substantial, particularly during a recession. Our objective was to evaluate factors associated with unemployment among gynecologic cancer patients in a nationally representative survey. <h3>Methods:</h3> A retrospective cohort of women ages 18-64 reporting employment currently or in the past, denying retirement, and endorsing care related to a gynecologic malignancy was identified in the 2007-2017 Medical Expenditure Panel Survey (MEPS). Survey weights were applied to generate national estimates of unemployment and job disruption (job change or loss) among the study cohort compared to the overall US population. We considered patient characteristics and healthcare utilization. Adjusted Wald statistics were used to compare employment outcomes between groups. Weighted multivariable logistic regression was utilized to assess factors independently associated with unemployment. <h3>Results:</h3> Of the 839 respondents with a gynecologic malignancy, 516 reporting current or past employment were identified. This cohort represents an estimated yearly average population of 434,000 (95% CI 370,000-498,000) that is mostly Caucasian (87%) with a mean age of 44.6 years. Compared to the overall US population, gynecologic cancer patients reported more non-cancer comorbidities (1.3 vs. 0.72, <i>P</i><0.001) and had a higher rate of low income (28.4% vs 16.0% <138% federal poverty level). Patients reported a similar rate of employment disruption (18.1% vs 17.1%, <i>P=0.62</i>), but a higher rate of part-year unemployment (44.1% vs 24.5%, <i>P</i><0.001), and year-round unemployment (24.3% vs 9.6%, <i>P</i><0.001) compared to the overall working US population. Among those with part-year employment, gynecologic cancer patients reported higher rates of productivity loss: 66.1% vs 39.9 % reported any missed workdays (<i>P</i><0.001) and more days of missed work secondary to illness or injury (10.7 vs 3.0 per year, <i>P</i><0.001). Among gynecologic cancer patients, job disruption and part-year unemployment were associated with an increased risk of at least one-month of uninsurance (45.4% vs 16.7%, <i>P</i><0.001; 42.8% vs 16.8%, <i>P</i>=0.001, respectively). Privately insured patients were less likely to be unemployed compared to those covered by Medicaid (27.6% vs 72.6%, <i>P</i><0.01). An increase in annual days of healthcare utilization was associated with an increased risk of part-time unemployment: the risk if 5+ days was 70.0% (57-83%), 10+ days 91.2% (81-100%), 15+ days 95.9% (90-100%), and 20+ days 99.5% (98-100%). In a multivariable analysis, lack of a high-school degree, and utilization of healthcare services for more than 5 days were independently associated with part-time unemployment (OR=5.86, <i>P</i><0.001; OR=3.45, <i>P</i>=0.002 respectively). No differences over time were identified comparing the recession (2007-2010) to post-recession (2010-2017). <h3>Conclusions:</h3> Gynecologic cancer patients experienced higher rates of unemployment, and loss of productivity compared to the overall US population. Disrupted employment was associated with at least one month of no health insurance coverage, and lack of a high school degree and increased healthcare utilization were independently associated with unemployment. While there was no association between the 2008 financial crisis era and unemployment, these data may help identify patients vulnerable to employment loss and health insurance loss during the current recession.