Delay in seeking treatment for the symptoms of myocardial infarction can contribute to significant mortality and morbidity. Although pre-hospital delay is a serious problem in both women and men, women appear to delay substantially longer than men. Possible reasons for longer delay in women include the age at which women experience first myocardial infarction, the presence of certain chronic diseases, possible atypical presentation of cardiac symptoms in women, and physician and layperson misperception of the significance of chest pain in women. Recommendations for studying the problem of pre-hospital delay in women and for designing future interventions to reduce delay are discussed.