Women are underrepresented in academic rank in critical care medicine (CCM), even after adjustment on sex ratio (25–35% of intensivists). Women faculty suffer from a publication gap (lower h-index, less likely to be attributed research grants). Women are also underrepresented in meetings (as speakers and chairs), editorial boards of journals and scholarly societies. Such a gap can be explained by several factors. Firstly, women are more likely to get involved in teaching, in clinical and community tasks. Secondly, the parental and domestic charge remain for a great part allotted to women. Thirdly, women face discrimination and sexual harassment. Finally, unconscious bias is involved in the gender gap, implying women’s hierarchy (different expectations towards men and women, gender stereotypes), but also inner unconscious bias preventing women for considering academic career. This is why, even after adjusting on publications, research and funding, the gender gap persists. The mechanisms involved in the lack of diversity (ethnic, disability) in academic medicine are like the gender gap mechanisms. Only ambitious, multifaceted, structural and educational policies can fill the gender gap in academic medicine, including CCM.