Women remain underrepresented in orthopedic surgery, accounting for only 13% of surgeons in Europe despite forming the majority of physicians overall. Structural barriers, including limited mentorship and work-life challenges, continue to hinder progress. To address these issues, the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) launched the Women in ESSKA initiative in 2018, fostering mentorship, leadership and visibility. Female membership and congress participation have since more than doubled, reflecting steady progress. Sustained equity efforts must extend beyond participation numbers to include transparent leadership pathways and fair representation in authorship and decision-making. True progress will depend on collaboration between women and men alike, ensuring that gender equity in orthopedics strengthens, not replaces, the core value of merit-based excellence.
LEVEL OF EVIDENCE: Level V.