The wage gap between men and women in the physician assistant (PA) profession has followed the evolution of trends and cultural shifts in both medicine and the broader US workforce. Although the gap has narrowed both nationally and, more specifically, within the PA profession, female PAs make on average $11,000 (or 6%) less than their male counterparts. The rate at which the wage gap is closing in the United States has slowed indicating that the remaining causes of the problem are subtle and difficult to address. This article discusses contributing factors such as implicit bias, workplace culture, modern family structure in the context of outdated expectations, female PA self-undervaluing, and weak consequences for violation of existing labor laws. Solutions may include legislation to further protect and empower women in the workplace, campaigns from PA professional organizations that can influence the profession's cultural landscape and empower PAs to know their worth, PA educators including contract negotiation as part of the curriculum, and employers addressing systemic hiring processes that undervalue female PAs.