Cardiovascular diseases (CVD) represent a significant global health burden, responsible for a substantial portion of morbidity and mortality worldwide. While CVD affect both men and women, growing evidence highlights distinct sex differences in the prevalence, presentation, risk factors, and outcomes of these diseases. Understanding these sex-specific nuances is essential for providing effective healthcare during the acute phase of the event, as well as tailored treatment options and follow-up. This review aims at exploring current knowledge in the field of gender differences across most common cardiovascular conditions in the spectrum of acute coronary syndromes (ACS), highlighting the intricate interplay of biological, hormonal, and sociocultural factors that underline sex differences in cardiovascular diseases, shedding light on the unique challenges and opportunities in preventing, diagnosing, and managing CVD in both men and women. As we delve deeper into this subject, it becomes evident that recognizing and addressing these disparities is a crucial step towards improving cardiovascular health on a global scale on one side, paying attention to the need of tailoring strategies to specific groups of patients on the other.