Cardiovascular disease is highly prevalent and the leading cause of mortality, both globally and in Croatia. This review article provides a detailed overview of the current knowledge regarding differences in the anatomy and physiology of the heart, as well as the most common cardiovascular pathologies between men and women. Although seemingly identical, male and female hearts differ in many aspects. Although not yet thoroughly researched, gender differences ultimately contribute to potentially distinct occurrences of cardiovascular conditions and diseases, their varying manifestations, responses to therapy, and treatment approaches. For instance, female hearts have smaller cavities, thinner walls, lower stroke volume, higher heart rate, and a longer QT interval on the electrocardiogram. Women manifest atherosclerotic heart disease later due to the protective effects of estrogen. Women are more prone to atypical presentations in acute coronary syndrome, which may lead to delays in appropriate treatment. They are more likely to experience heart failure with preserved ejection fraction, microvascular coronary artery disease, or Takotsubo cardiomyopathy, whereas men more frequently suffer from heart failure with reduced systolic function and macrovascular coronary disease. Most of the knowledge regarding the etiology, clinical presentation, and treatment of cardiovascular diseases stems from research conducted over decades, predominantly on male participants. Despite the extensive existing literature on gender differences in cardiovascular health and disease, there is a need for further research to reduce discrepancies in the approach and outcomes of treatment between men and women.