Introduction: Previously we reported that ischemic stroke incidence is declining over time for men but not women. We sought to describe temporal trends of sex differences in TIA incidence within a large, biracial population. Methods: Among the biracial population of 1.3 million in the Greater Cincinnati Northern Kentucky Stroke Study (GCNKSS) region, all first-ever transient ischemic attacks (TIAs) among area residents (≥20 years old) were identified at all local hospitals. Out of hospital cases were ascertained using a sampling scheme. All cases were reviewed by study physicians. Sex-specific TIA incidence rates over time (during 7/93-6/94 and calendar years 1999, 2005, and 2010) were determined. Incidence rates were calculated using the age-, race-, and sex-specific number of TIAs divided by the population in that group; rates were standardized to the 2010 U.S. population. Statistical testing for differences over time was done using linear regression models adjusted for age and race. The delta method was used to estimate the ratio of female to male TIA incidence and the associated standard error (SE). Results: There were a total of 3203 patients with incident TIA; 54% were female, and 12% were black. Overall, mean age for men was 66 (SE 0.36) compared to 71 (SE 0.33) for women, p=0.01. Compared with men, women had lower rates of TIA in all 4 study periods, and TIA incidence rates were stable over time for women (p=0.19) and men (p=0.12). (See table). TIA patients were younger in 2010 than in 1993/4 and 1999 (P<0.05) with means of 68 (SE 0.53), 70 (SE 0.50) and 71 (SE 0.47) respectively. Conclusions: Within the GCNKSS population, women had lower TIA incidence rates than men. In contrast to what we have previously described in ischemic stroke incidence, neither the sex difference in incidence nor the sex-specific incidence rates are changing over time. Further research is needed to understand the drivers of higher TIA incidence in men and the lack of change in TIA incidence over time.