The purpose of the present review is to summarize the current knowledge on the impact of gender on urological cancers. There is a discrepancy in the incidence of urothelial and kidney cancers, with a higher prediction for male patients. Men have a three-times greater risk of developing bladder cancer compared to women, but female gender has been identified as an independent adverse prognostic factor for both disease recurrence and progression. At diagnosis, men with renal cell carcinoma present more often with larger tumors and higher stage and grade disease compared to females. Smoking habits, tumor biology, sex steroid hormones, genetic differences and social behavior may be the main drivers of gender disparities. Therefore, the inclusion of this variable in validated prognostic tables and nomograms should be concretely discussed.