Our understanding of aortic aneurysms in females has been derived from large data sets with a preponderance of male patients. Currently, the approach to females with aneurysms is a direct and unadjusted translation of the concepts established in our practice with men. Although a very few studies, often with the lower-profile devices, have suggested the outcomes may not be different between men and females, a larger proportion of studies have frequently identified worse outcomes for females across almost every aspect of aneurysm care (Table 1) [1], [2], [3]. These findings exist despite adjustment for age, comorbidities, and traditional risk factors, suggesting that aneurysms represent an inherently higher-risk disease process in the females sex. The underlying factors that influence this pronounced disparity have been largely unexplored. Without a better understanding of the factors that influence inferior outcomes, improvements are unlikely to be made. No prior research syntheses are available on this subject, prompting an exploratory study in the form of a scoping review. First, we aimed to identify key studies unearthing factors linked to sex-based disparities. Second, we identified several interrelated themes in the care of females with aneurysms, each of which forms an avenue for future research directives.