Statistics documenting the relentless rise of women in American medicine, primary care specialties, and surgery are presented. Representation of women in many surgical societies, on journal editorial boards, and in surgical texts does not appear to have kept pace. The participation of women surgeons in each of these activities ranges from 0.8% to 1.7%, equivalent to the percentage of women in general surgery before 1975. Comparison is made with women surgeons in an open national society (8.2%), an open regional society (6.9%), an open editorial board (7.5%), and a recently published textbook of surgery (8.2%). These proportions parallel the current 6.3% of women in general surgery and support the premise that women are at least as likely as their male colleagues to participate in the professional activities of the surgical establishment. During the waning years of the 20th century, ever-increasing numbers of qualified women will come forward to join the hierarchy of American surgery.