AbstractTo provide information for targeted support of female scientists, the objective of this study was to evaluate how female authors are represented in journals of five medical disciplines with varying rates of female physicians from the United States of America (USA), Europe, and Asia. For this retrospective bibliometric study 15 representative gynecologic, pediatric, radiologic, urologic, and surgical journals from the USA, Europe, and Asia were selected from the Web of Science database. From these, all n = 24182 publications of the years 2007/2008 and 2017/2018 were included. Gender and affiliations were assigned to first and senior authors using a software (Gender API, Passau, Germany), native speakers, and a web-based search. For statistics mixed logistic and multinomial logistic regression were applied. In pediatrics, radiology, and urology, highest female first and senior author shares were consistently found in journals from the USA. In European journals proportions across all disciplines tripled (odds ratio 2.96 [95% CI 2.60–3.37], P < .0001). Asian journals showed three-times fewer female authorships than journals from the USA or Europe and the smallest increase (1.36 [1.11–1.66], P = .0026). Compared to the proportion of female physicians within each specialty, female first authors remained underrepresented in Asian journals and female senior authors in journals of all regions. In journals from the USA most female authors originated from institutes within the USA (36.2%), in European journals from the USA (21.1%) or Europe (21.7%). Women from Asian institutes were worst represented in journals of all regions with lowest rates in Asian journals (9.4%). In conclusion female first authors remained underrepresented in Asian journals, female senior authors and women from Asian institutes in journals from all regions. Programs for gender equality in science are thus particularly necessary to support female senior authors, for Asian journals, and women from Asian institutes.