Chest pain is a common presenting symptom among emergency department (ED) patients, reported as the second most common reason for visiting the ED in the United States. Though many symptoms of chest pain related to acute coronary syndrome are similar among men and women, differences in underlying pathophysiology, risk factors, and the coexistence of atypical symptoms predispose women to potential treatment delays and poor outcomes. Women experience increased rates of mortality following an acute myocardial infarction; however, through development of strategies to increase recognition of symptoms, minimize prehospital delays, and increase the rate of medical treatment, we may impact these detrimental clinical outcomes.