Background <p>Gender representation in academic leadership varies across medical specialties and leadership roles. This study examined female representation among department chairs and residency program directors across ophthalmology subspecialties in U.S. academic institutions.</p> Methods <p>Data on department chairs and residency program directors were obtained from the Association of University Professors of Ophthalmology (AUPO) and updated to January 1, 2025. Female representation was calculated by determining the proportion of women in leadership roles within department chairs and residency program directors across ophthalmology subspecialties. Chi-square goodness-of-fit and Fisher exact tests were used to evaluate differences in gender representation.</p> Results <p>A total of 117 academic ophthalmology programs were included. Female representation was significantly lower among department chairs (18.8%, <i>p</i> = 0.046) than residency program directors (44.4%, <i>p</i> = 0.752). Gender representation varied across ophthalmology subspecialties, with uveitis being the only subspecialty showing a statistically significant difference among program directors (0%, p = 0.041).</p> Conclusions <p>Women are significantly underrepresented among ophthalmology department chairs overall. Representation among residency program directors did not differ significantly from expected benchmarks, with the exception of uveitis program directors. Continued efforts are needed to support gender equity in academic ophthalmology leadership.</p>