Men may be more likely than women to die outside the hospital from coronary artery disease, whereas women may be as likely as men to die inside the hospital. This study used Washington State death records to compare death rates from coronary artery disease inside and outside the hospital for women and men from 1980 to 2001. For in-hospital deaths, the men:women ratio of deaths was 1.6 in 1980 and 2001; for out-of-hospital deaths, the ratio decreased slightly from 2.6 in 1980 to 2.3 in 2001. These findings support the contention that, despite significant decreases in mortality, men continue to have higher rates of death outside and inside the hospital than do women, although there has been a slight decrease in male:female mortality for deaths outside the hospital.