Background and Objectives Pathological gambling often co‐occurs with other psychiatric disorders. Gender differences in treatment‐seeking behaviors among patients with pathological gambling diagnosis remain poorly understood. This study assessed gender differences in healthcare services utilization in patients seeking treatment for pathological gambling, substance use, and mental health co‐occurring conditions. Methods Study data were derived from a representative sample of the Massachusetts All Payers Claims Database for the period 2009–2013. Descriptive analyses were performed by gender using group t‐tests and Pearson's chi‐square tests. Bootstrap analysis was used to account for skewed distribution of healthcare services utilization data. Multiple linear regressions were used to evaluate the association between healthcare services utilization and gender while controlling for patient's age, county, and ICD‐9‐CM diagnosis codes. Results Over two‐thirds of the patients were males. Moreover, two in five patients seeking treatment had pathological gambling as principal or primary diagnosis. Females had a significantly greater number of three or more co‐occurring psychiatric conditions than males. Having a diagnosis of episodic mood disorder, neurotic disorder, or adjustment reaction significantly increased the utilization of healthcare services for both genders. Females had a greater utilization of healthcare services than males for the same psychiatric diagnosis. Discussion and Conclusions Healthcare services utilization significantly varies by gender and type of mental health and substance use diagnosis. There are significant differences by gender in the utilization of healthcare services for the same psychiatric disorders. Scientific Significance There is a need to address gender differences in psychiatric conditions and their related healthcare needs. (Am J Addict 2018;XX:1–7)

Psychiatric comorbidity and substance use disorders, and nondependent abuse of drugs are highly prevalent among pathological gamblers. These disorders pose an economic burden to patients and healthcare payers.