Coronary artery disease is the leading cause of death in both men and women worldwide. Little is known about gender-based differences in lipid goal attainment during secondary prevention of coronary artery disease. We conducted this study to analyze gender differences in low-density lipoprotein cholesterol target attainment in secondary prevention after acute myocardial infarction over a 5-year period. In this retrospective study, the electronic database of lipid clinic at a single center was used as the data source. Temporal trends and gender differences in demographics, lipid profile, and medication use were determined. Goal low-density lipoprotein (LDL) was defined per National Cholesterol Education Program ATP III guidelines.A total of 1365 patients (823 males, 542 females) constituted the study sample. Patients in 2007 were older than those in 2003 (females 68.6 ± 14 vs. 70.7 ± 11.7 years; males 63.6 ± 12 vs. 65.8 ± 11 years; P < 0.05) and had a higher body mass index (females 27.8 ± 1 vs. 28.6 ± 1 kg/m; males 27.6 ± 1 vs. 28.1 ± 1 kg/m, in 2003 and 2007 respectively, P < 0.05). Mean LDL decreased significantly overtime in both males and females. No gender difference in lipid-lowering therapy was observed. Females had a higher LDL than did males in 2003 (115.3 ± 12.3 vs. 99.7 ± 12.5 mg/dL; P < 0.05), and this difference persisted through 2007 (102.2 ± 11.7 vs. 91.3 ± 11.2 mg/dL; P < 0.05). Overall rate of achieving goal LDL improved from 76.5% (2003) to 83.02% (2007), P < 0.05, but remained lower for females than for males both in 2003 and 2007 [69.8% vs. 80.1% (2003), P < 0.05, and 77.9% vs. 85.6% (2007), P < 0.05].The trend over a recent 5-year period shows that females are less likely to achieve goal LDL than males are, and it indicates the need for more aggressive lipid-lowering strategies in females.