The following study examines changes in representation of women among first authors of original research published in high impact general medical journals from 1994 to 2014, and investigates differences between journals. Results indicate that the representation of women among first authors of original research in high impact general medical journals was significantly higher in 2014 than 20 years ago, but it has plateaued in recent years and has declined in some journals. The underlying causes need to be investigated to help to identify practices and strategies to increase women’s influence on and contributions to the evidence that will determine future healthcare policies and standards of clinical practice.