To evaluate differences in burnout and career satisfaction between men and women surgeons and to determine the relationships among personal factors, professional characteristics, and work-home conflicts. Cross-sectional study, with data gathered through a survey. The United States. Members of the American College of Surgeons. Burnout and career satisfaction. Of approximately 24,922 surgeons sampled, 1043 women and 6815 men returned surveys (31.5% response rate). Women surgeons were younger, less likely to be married, less likely to be divorced, and less likely to have children (all P < .001). No differences between women and men in hours worked or number of nights on call per week were observed. Women surgeons were more likely to believe that child-rearing had slowed their career advancement (57.3% vs 20.2%; P < .001), to have experienced a conflict with their spouse's/partner's career (52.6% vs 41.2%; P < .001), and to have experienced a work-home conflict in the past 3 weeks (62.2% vs 48.5%; P < .001). More women than men surgeons had burnout (43.3% vs 39.0%; P = .01) and depressive symptoms (33.0% vs 29.5%; P = .02). Factors independently associated with burnout on multivariate analysis were generally similar for men and women and included recent experience of a work-home conflict, resolving the most recent work-home conflict in favor of work, and hours worked per week. Work-home conflicts appear to be a major contributor to surgeon burnout and are more common among women surgeons. Although the factors contributing to burnout were remarkably similar among women and men surgeons, the women were more likely to experience work-home conflicts than were their male colleagues.