Introduction: Patients with possible coronary insufficiency should undergo aggressive treatment to minimize the pain, since chest pain is a correlate of myocardial ischemia and injury. Patient gender should not affect the intensity of therapy. METHODS: A retrospective run-sheet review from a large prehospital system (684 paramedics E.M.S. approximately 17,000 runs/year) was done to determine the gender of the lead paramedic, the gender of the patient and the chest pain score difference pre-and post-treatment. Treatment included standard therapy of oxygen, nitroglycerin and morphine. A pain score of 0-10 was used. All runs with “chest pain” as the chief complaint were reviewed from 4/2007 to 7/2008. 225 cases were found. 2 sample poison test was used to analyze the data. Results: When female E.M.T.P’s treat female patients vs. Treating male patients, the pain score difference is 1.77 (p=0.010) When male E.M.T.P’s treat male patients vs. Female patients the pain score difference is 0.57 (p=0.063) Conclusions: Female FF/EMTP treat female patients more aggressively for chest pain than when they treat male patients. This may be due to gender bias and expectation of pain tolerance by male patients. Male FF/EMTP treats male and female patients with the same intensity.