Aim: Despite the significant increase in the proportion of graduating female physicians in recent decades, gender representation in surgical training remains imbalanced. The initial rise in female interest in plastic surgery has reached a plateau. Gender bias, affecting women’s confidence and opportunities, negatively impacts training and career prospects. This study aims to quantify and analyze disparities in surgical training opportunities, workplace treatment, and career advancement among male and female plastic surgery residents in Italy. Methods: Our study involved all Italian plastic surgery residents contacted between February and March 2024. A 21-item survey assessed professional, surgical, and personal aspects, focusing on gender gap differences. Responses were expressed in percentages and compared utilizing the Fisher Exact test. Results: A total of 551 surveys were distributed to Italian plastic surgery residents, with 46 responses each among women and men. Gender disparities persisted in workplace treatment, with more women reporting discrimination. Significant differences were identified in treatment inequality by hospital personnel and patients, the occurrence of inappropriate comments in the workplace, inquiries regarding work-life balance and career advancement opportunities, an augmented gender gap in surgical vs . clinical programs, and the perception of a negative impact of gender on surgical training. Conclusion: In conclusion, our study emphasizes the pervasive gender inequality in plastic surgery training, urging action against systemic biases hindering female surgeons’ progress. Gender equity efforts should combat discrimination, promote work-life balance, and foster inclusive training environments. Addressing these issues can create a field that empowers all surgeons to thrive.