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Type 2 myocardial infarction (T2MI) occurs due to an imbalance between coronary blood supply and myocardial oxygen demand, leading to ischemia without the rupture of an atherosclerotic plaque, distinguishing it from Type 1 myocardial infarction (T1MI). Although T2MI is frequently diagnosed in clinical practice and associated with a poor prognosis, there is limited understanding of the sex differences in this condition, despite women representing a higher proportion of T2MI cases compared to T1MI. This review explores the definitions, epidemiological aspects, and clinical scenarios that reveal significant differences in T2MI between men and women that contribute to disparities in outcomes. It examines the unique roles that sex and gender play in the development, presentation, and diagnosis of T2MI, emphasizing the need for greater awareness of these factors. Understanding how these differences contribute to this condition is essential for developing patient-tailored approaches to managing this often-undervalued disease and improving outcomes.