Sudden cardiac death is most often caused by ventricular dysrhythmias. Although women have an incidence of sudden death lower than that of men, 34% of coronary deaths in women are sudden deaths. The atherogenic risk factors do not predict which women are at the highest risk of sudden cardiac death. Left ventricular hypertrophy is a strong risk factor for sudden cardiac death in women. Asymptomatic ventricular dysrhythmias, a risk factor for death after myocardial infarction in men, do not increase the risk of death in women. This gender difference in the risk of sudden cardiac death deserves further attention, since it affects the evaluation of interventions designed to reduce the rate of sudden cardiac death.