This narrative review examines gender differences in borderline personality disorder (BPD). BPD is a complex mental disorder traditionally more prevalent in women, but recent studies show conflicting data in community samples. The review highlights differences in diagnosis, temperament, clinical characteristics, comorbidities, neuroimaging findings, and treatment attitudes between genders. Men were more likely to endorse criteria such as "intense and inappropriate anger" and "impulsivity," while women endorsed "chronic feelings of emptiness," "affective instability," and "suicidality/self-harm behaviors." Gender differences in comorbidity patterns were also observed, with women more likely to have internalizing disorders and men more likely to have externalizing disorders. Neuroimaging studies suggest gender differences in brain activity, particularly in the prefrontal cortex, striatum, and amygdala. Treatment utilization showed that women were more likely to seek help, while men used drug/alcohol rehabilitation services more frequently. Despite these findings, the evidence remains limited, and further research is needed to better understand gender differences in BPD. The review concludes that gender differences in BPD are complex and influenced by various factors, including diagnostic criteria, population sampling, and assessment methods.This narrative review examines gender differences in borderline personality disorder (BPD). BPD is a complex mental disorder traditionally more prevalent in women, but recent studies show conflicting data in community samples. The review highlights differences in diagnosis, temperament, clinical characteristics, comorbidities, neuroimaging findings, and treatment attitudes between genders. Men were more likely to endorse criteria such as "intense and inappropriate anger" and "impulsivity," while women endorsed "chronic feelings of emptiness," "affective instability," and "suicidality/self-harm behaviors." Gender differences in comorbidity patterns were also observed, with women more likely to have internalizing disorders and men more likely to have externalizing disorders. Neuroimaging studies suggest gender differences in brain activity, particularly in the prefrontal cortex, striatum, and amygdala. Treatment utilization showed that women were more likely to seek help, while men used drug/alcohol rehabilitation services more frequently. Despite these findings, the evidence remains limited, and further research is needed to better understand gender differences in BPD. The review concludes that gender differences in BPD are complex and influenced by various factors, including diagnostic criteria, population sampling, and assessment methods.