BACKGROUND AND OBJECTIVE: To evaluate the impact of sex differences on the presenting features, treatment patterns, and clinical outcomes in patients with central retinal vein occlusions (CRVO). PATIENTS AND METHODS: This retrospective, longitudinal cohort study included 476 patients diagnosed with CRVO over a 7-year period. Charts were reviewed and clinical data were abstracted. RESULTS: The average age at CRVO onset was lower in males (63.8 years vs. 66.1 years; P = .048). More males (104/224, 54%) had an ischemic CRVO compared to females (113/252, 45%) at 12 months (P = .05). Males with CRVO had a greater central subfield thickness at the baseline (546.7 ± 306.8 μm vs. 438.4 ± 252.9 μm; P = .003) and final visits (343 ± 179.5 μm vs. 304.6 ± 176.2 μm; P = .005). Foveal avascular zone enlargement was more likely in males (39/102, 38% vs. 29/116, 25%; P = .04). CONCLUSIONS: Sex differences exist in presenting features of patients with CRVO. Further inquiry may help provide individualized recommendations for management of CRVO. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:279-285.].