This study investigated gender differences in pain perception as characterized by pain symptoms in patients diagnosed with unstable angina pectoris. Twenty-nine women and 32 men were asked to characterize their chest pain using a semi-open questionnaire assessing pain intensity (by numerical rating), pain location, pain characteristics, complaints following chest pain, factors that evoked or reduced chest pain, and whether the chest pain was related to heart disease. Significant gender differences were found. Women scored the intensity of their chest pain significantly higher than men (Chi-square 14.8, P < 0.0001), and related their chest pain less to heart disease (Chi-square 24.6, P < 0.0001). The women described an atypical clinical picture of chest pain that was significantly different from men's. The results are discussed in light of pschological theories regarding gender differences in pain perception. These findings imply the need for special attention to the unique clinical pictures that appear for women and men.