Traumatic brain injury (TBI) is a leading cause of death and disability, and the highest in-patient admission rates are among older adults. We identified that gender independently influences discharge destination following TBI in older adults. In this cross-sectional study, we examined discharge destinations of patients admitted to acute care over a 4-year period, as captured by the Ontario Trauma Registry (n = 3,480). Following TBI, women were significantly more likely than men to be sent to long term care facilities rather than home settings (p < .05), controlling for age, injury severity, mechanism of injury, and comorbidities.