Despite the consistently reported gender parity among accepted applicants to US medical schools, upstream parity in surgical training, academic promotion, leadership positions, pay equity, grant funding, and efforts to promote wellness specific to the needs of women surgeons is seriously lacking. Along with these known disparities, women surgeons disproportionally suffer from gender bias, micro-aggressions, bullying, discrimination, and harassment that together create an unjust, unsafe, undignified, intolerable if not hostile work environment. This chapter will explore these issues and offer a landscape that will set the stage for future initiatives to invoke change.