The nucleus accumbens is a limbic nucleus, representing part of the striatum body, and together with the caudate nucleus and putamen, it lies on the septum. The aim of this study was to examine morphological sexual dimorphism in spine density and also to undertake an immunohistochemical study of expression for estrogen and progesterone receptors in the medium-sized neurons in the nucleus accumbens. The research was conducted on twenty human brains of persons of both sexes, between the age of 20-75 years. The Golgi method was applied to determine the types and subtypes of neurons, morphologies of soma, dendrites and axons, as well as the relations between the cells and glial elements. The following were quantitatively examined: the maximum diameter of the neurons, the minimal diameter of the neurons, and the total length of the dendrites. The expression of receptors for estrogen and progesterone, their distribution and intensity were defined immunohistochemically. The parameters of the bodies of neurons in the shell and core of the nucleus accumbens were studied in both men and women. No statistically significant differences were found. Examination of the spine density showed statistical significance in terms of a higher density of spines in women. Immunohistochemically, in the female brain estrogen expression is diffusely spread in a large number of neurons; it is extra nuclear, of granular appearance and high intensity. In the male brain, expression of estrogen is visible and distributed over about one half of different types of neurons; it is extra nuclear, of granular appearance, mostly of middle and low staining intensity. Expression of progesterone in the female brain was very discreet and on a very small number of neurons; it was extra nuclear and with a weak staining intensity. Expression of progesterone in the male brain was distributed on a small number of neurons. It had a granular appearance, it was extra nuclear, with a very low staining intensity. Our results show differences in the morphology as well as expression of receptors for estrogen and progesterone on medium-sized neurons with spines in the nucleus accumbens of men and women.