Most people are aware of subtle differences in cognitive functions between men and women. Psychometric tests confirm specific gender differences in a number of areas, the most robust being in spatial orientation and mathematical tasks which are better performed by males. Nonetheless, normal males and females perform comparably on intelligence tests and human brains lack sexual dimorphism on routine neuropathological exams--other than mean differences in weight and size. Even so, human brains demonstrate: 1) a sexually dimorphic nucleus in the hypothalamus with twofold neuronal numbers in males than in females; 2) the planum temporale/anterior Sylvian fissure on the left side are larger in males; 3) some studies reveal the posterior corpus callosum to be more bulbous in females while others fail to show this difference; and 4) a cytoarchitectural study demonstrates definite sexual dimorphism of cerebral cortex with significantly higher neuronal densities and neuronal number estimates in males and a reciprocal increase in neuropil/neuronal processes in female cortex as implied by the 2 sexes' similar mean cortical thicknesses. Such morphologic differences may provide the structural underpinning for the gender differences exhibited by the normal and diseased brain. Males manifest a higher prevalence of mental retardation and of learning disabilities than females which may reflect the male fetus' smaller overproduction of nerve cells. Such an inference is supported by the demonstration of 1) better functional recovery following early brain injury than after later insults, 2) substantially overproduced and secondarily reduced nerve cells in human cerebral cortex during gestation, 3) the demonstration of a similar neuronal production and a testosterone-dependent neuronal involution of the sexually dimorphic hypothalamic nucleus in rats, and 4) more cortical neurons present in the adult human male than female. If an overproduced nerve cell population is capable of compensating for pathologic nerve cell losses taking place during the process of neuronal involution, the magnitude of overproduced nerve cells may define the extent of the protection conveyed. Because male fetuses appear to involute fewer overproduced cortical neurons than females, this gender difference could explain in part the boys' greater functional impairments from early brain damage. Women, on the other hand, exhibit a higher incidence and prevalence of dementia than do men. Given the females' overall larger extent of cortical neuropil (neuronal processes) and lower neuronal numbers compared with men, any disease that causes neuronal loss could be expected to lead to more severe functional deficits in women due to their loss of more dendritic connections per neuron lost. In conclusion, superimposed on a strong background of functional and structural equality, human male and female cerebral cortex display distinct, sexually dimorphic features, which can begin to be linked to a complex array of gender-specific advantages and limitations in cognitive functions.