This narrative review examines gender differences in borderline personality disorder (BPD) in terms of diagnosis, temperament and clinical characteristics, comorbidities, neuroimaging findings, and treatment attitudes. Despite traditional findings suggesting BPD is more prevalent in females, recent studies have shown conflicting data. The review highlights that men are more likely to endorse criteria for intense and inappropriate anger and impulsivity, while women are more likely to endorse chronic feelings of emptiness, affective instability, and suicidality/self-harm behaviors. These differences reflect variations in temperament and symptoms between genders. Other significant differences include comorbidity patterns, specific neurobiological mechanisms, and treatment attitudes. Studies specifically investigating gender differences in BPD are limited, often lacking a balanced gender sample. The review also discusses the potential biases in diagnostic criteria, population sampling, and evaluation instruments that may contribute to the observed heterogeneity. Overall, the findings suggest that while there are some gender differences in BPD, the majority of studies have not found statistically significant differences in clinical manifestations and symptom domains.This narrative review examines gender differences in borderline personality disorder (BPD) in terms of diagnosis, temperament and clinical characteristics, comorbidities, neuroimaging findings, and treatment attitudes. Despite traditional findings suggesting BPD is more prevalent in females, recent studies have shown conflicting data. The review highlights that men are more likely to endorse criteria for intense and inappropriate anger and impulsivity, while women are more likely to endorse chronic feelings of emptiness, affective instability, and suicidality/self-harm behaviors. These differences reflect variations in temperament and symptoms between genders. Other significant differences include comorbidity patterns, specific neurobiological mechanisms, and treatment attitudes. Studies specifically investigating gender differences in BPD are limited, often lacking a balanced gender sample. The review also discusses the potential biases in diagnostic criteria, population sampling, and evaluation instruments that may contribute to the observed heterogeneity. Overall, the findings suggest that while there are some gender differences in BPD, the majority of studies have not found statistically significant differences in clinical manifestations and symptom domains.