Women with cardiac diseases generally have a higher mortality than men. Suggested reasons include delay in reporting to hospital, less aggressive management, and higher cardiovascular risk profiles in women. We assessed gender differences in patients hospitalized with dizziness. We retrospectively reviewed the database of patients hospitalized with acute cardiac disease in Qatar from 1991 to the end of 2010. Patients hospitalized with dizziness were analyzed; 1611 (3.8%; 95% confidence interval [CI]: 3.6%-4%) of the total N = 42 144 patients were hospitalized with dizziness during the 20 years: 410 (25.5%) females and 1201 (74.5%) males. Mean age (female 55  and male 53  years) was comparable (P = .06). Women had more hypertension, diabetes mellitus, palpitation, and arrhythmia compared with men. In-hospital mortality was 3.8% (women 5.6% vs men 3.2%, P = .03). After adjusting for potential confounders, female gender remained an independent factor for increased in-hospital mortality (adjusted odds ratio: 2.2, 95% CI: 1.21-4, P = .01). In this 20-year data set from a Middle Eastern country, female gender was an independent factor associated with increased in-hospital mortality in patients hospitalized with dizziness after adjusting for confounders. Further research is warranted to confirm this novel gender difference.