Objectives/Background <p>Women are underrepresented in prestigious authorship positions. As per the Canadian Medical Association (CMA), 31.3% of emergency department (ED) physicians identify as women or female. This is the first study to explore whether the corresponding gender/sex proportion of ED physicians in Canada each year is reflected in prestigious authorship in the Canadian Journal of Emergency Medicine (CJEM) between 2000 and 2019.</p> Methods <p>A cross-sectional analysis was conducted of the first and last authors of original research articles in the CJEM from 2000 to 2019. Our data collection yielded 623 original research articles. Descriptive statistical techniques were used to analyze authorship in the CJEM and the proportion of women/female emergency physicians in Canada over the twenty-year period.</p> Results <p>Of 623 total articles, 64.7% have a man as the first author and 35.3% have a woman as the first author. Of 546 articles with three or more authors, 72.0% have a man as the last author and 28.0% have a woman as the last author. There are several years where the proportion of women in first or last authorship is lower than the proportion of women/females in emergency medicine.</p> Conclusions <p>Our study shows that the proportion of women in prestigious authorship positions in the CJEM exceeds the proportion of women/female ED physicians in Canada between the years of 2000 and 2019. As the proportion of women/females has increased in emergency medicine, the proportion of women with prestigious authorship positions has also increased in the CJEM. This suggests that emergency medicine in Canada may be a welcoming field for women who want to publish research at a prestigious level and practice medicine.</p>