Objective: To assess the proportion of women who presented research or medical grand rounds at five major academic hospitals in Canada. Design: A cross sectional study. Setting: Five major university–affiliated hospitals in Toronto and Calgary. Results: Overall, at all sites and types of academic rounds, there were an average of 17% fewer women presenting than men (p < 0.001). There were an average of 32% and 21% more men presenting at the city wide grand rounds in City A and B respectively (p < 0.001, p = 0.002). There were more male speakers at 4 out of 5 types of rounds. The proportion of women presenting on average was proportional to the Canadian workforce, but on average, below the proportion of female residents and medical students (median ratio 1.1, 0.7 and 0.8 respectively). Conclusion: Our study demonstrated a lower proportion of females in an important outlet for academic recognition and role modeling. This provides a possible contributing factor to the under representation of women in academic medicine, and an area that can be systematically targeted to promote equity.