Background: To assess relationships between gender, ocular parameters and ocular diseases. Methods: The Beijing Eye Study is a population-based study including 4,439 Chinese. All participants underwent a detailed ophthalmic examination, anthropometric measurements and analytic blood examinations. Results: In multivariate regression analysis, female gender was significantly associated with a shallower anterior chamber (p < 0.001) and narrower anterior chamber angle (p = 0.001), higher prevalence of dry eye (p = 0.002), lower best-corrected visual acuity (p = 0.04) and lower presenting visual acuity (p = 0.046), and with the systemic parameters of lower educational level (p < 0.001), rural region (p = 0.002), lower frequency of smoking (p < 0.001) and alcohol consumption (p < 0.001), lower body height (p < 0.001), lower diastolic blood pressure (p < 0.001) and higher systolic blood pressure (p < 0.001), and higher serum concentrations of triglycerides (p = 0.005), low-density lipoproteins (p < 0.001) and high-density lipoproteins (p < 0.001). Men and women did not vary significantly in refractive error, intraocular pressure, central corneal thickness, size of the optic disk and parapapillary atrophy, and prevalences of retinal microvascular abnormalities, trachoma, pterygia, nuclear cataract, posterior subcapsular or cortical cataract, angle-closure glaucoma, open-angle glaucoma, age-related macular degeneration and retinal vein occlusions. Conclusions: After controlling for systemic factors, females have a shallower anterior chamber, a narrower anterior chamber angle and a higher prevalence of dry eye. Copyright (C) 2010 S. Karger AG, Basel