The objectives of this study were to identify gender differences in relation to factors associated with oral health satisfaction among the elderly and to estimate the prevalence of edentulism by gender and age. The study included 2,052 elderly (≥ 60 years) residing in Sete Lagoas, Minas Gerais State, Brazil. Poisson regression was used to estimate prevalence of edentulism. The association between oral health satisfaction and independent variables was estimated using ordinal regression with a hierarchical multidimensional model. Prevalence rates for edentulism in males and females were 63% and 68.8%, respectively. Most elderly males (63%) and females (57%) were satisfied with their oral health. The final adjusted model for both genders consisted of variables related to environmental characteristics, health behaviors, and oral health conditions. The study concludes that oral satisfaction is heavily influenced by oral health status and health behaviors, while the associated factors differ by gender.