INTRODUCTION: Gender disparities exist in nonresearch industry payments to U.S. physicians, but detailed analyses specific to surgeons are limited. This study aims to investigate the gender pay gap in industry general nonresearch payments made to U.S. general and fellowship-trained surgeons between 2016 and 2022. METHODS: Data on industry payments to U.S. surgeons were collected from the open payments database. General and fellowship-trained surgeons were included. Gender prediction was conducted using an artificial intelligence tool. Payment type, amount, and company were summarized. Gender differences were compared. RESULTS: Between 2016 and 2022, the medical and device industry made 1,998,110 payments totaling 39,264,940 to U.S. general and fellowship-trained surgeons. The median payment was 1, primarily for food and beverages. Surgeons receiving over 000 annually accounted for 34,530,579 (86%). Most payments were device-related (92%). Intuitive (99M), Medtronic (7M), and Boston Scientific (6M) were the top-paying companies. California received the highest payments (0M). Payments peaked in 2019 before falling due to the COVID-19 pandemic. Men were paid significantly more than women, with an average 6,509 annual pay gap favoring men (P <
0.001). In 2019, the industry paid men 4,025 on average, compared to 6,677 for women. CONCLUSIONS: Among U.S. general and fellowship-trained surgeons, there is a gender pay gap in industry general payments, where males receive higher compensation for nonresearch-related reasons. Understanding the factors contributing to this disparity, such as differential access to industry opportunities and potential biases in compensation negotiations, is crucial for promoting equity in industry relationships.