Purpose.To compare the outcome of 145 women who underwent conventional total knee arthroplasty (TKA) with 77 women who underwent genderspecific TKA. Methods. Records of 222 women who underwent primary TKA using a conventional (n=145) or genderspecific (n=77) size E or F prosthesis for end-stage osteoarthritis were reviewed. The gender-specific prosthesis has a narrower mediolateral dimension. Patients were assessed for flexion, Oxford Knee Score, Knee Society function and knee scores, and Short Form-36 Health Survey preoperatively and postoperatively (at 6 months and 2 years). Results. The 2 groups were comparable in terms of age (67.8 vs. 68.1 years, p=0.789), body mass index (28.6 vs. 27.8 kg/m 2 , p=0.189), and preoperative scores. 12 women with conventional TKA and 4 women with gender-specific TKA were lost to followup. Compared with women with conventional TKA, women with gender-specific TKA had better flexion at 6 months (116° vs. 121.9°, p=0.007) and 2 years (118.7° vs. 124.6°, p=0.006), better bodily pain score at 2 years