Brief summary Women have increased incidence of device related thrombosis (DRT) after percutaneous left atrial appendage occlusion (PLAAO), which is associated with higher risk of stroke. However, there is paucity of female subjects in the pivotal trials leading to approval of PLAAO devices. There is lack of comparative studies investigating the impact of gender on DRT after PLAAO. We therefore performed meta-analysis to reconcile the actual risk in a large real world population which showed no difference in DRT in women versus men (RR 1.05, 95% CI 0.62–1.79, p = 0.8). The underrepresentation of women in these trials may create a bias and should be considered carefully when interpreting the results.