The occurrence of depression is higher in females after puberty, suggesting a gender-related difference. This article reviews studies that have examined gender differences in the presentation and treatment of depression in adults and discusses how this information applies to depressed children and adolescents. The adult literature suggests that men and women vary in presentation of depression. In addition, differences exist in the pharmacokinetic properties of various medications, but it is unclear how they affect clinical treatment response. Studies of gender differences in child and adolescent depression are limited. Some studies suggest that differences seen in adults may also apply to children and adolescents. Studies of gender differences in treatment response are not available, however. Further study and evidence-based exploration are required to better understand gender differences in depression in children and adolescents.