Although the translation of sex and gender evidence into clinical practice guidelines (CPGs) is strongly advised by specialists, this commitment may be limited to presenting findings on women for specific diseases and topics. The inclusion of sex and gender evidence should deploy available data on health and illness, taking human diversity into consideration, especially when drafting CPGs. This work examines 21 guidelines from Spanish CPGs from 2018 to 2022, scraping sex and gender evidence across documents under the lens of 59 keywords related to sex and gender. Three out of four CPGs included relevant keywords to analyse. Then the set of words was analysed in terms of their frequency, as well as the context of the words (nature and location of the information in the CPG). It found that masculine keywords were widespread in CPGs as a result of an androcentric orientation in clinical research, except for those CPGs centred on women’s issues. CPGs focused on technical procedures tended to omit considerations regarding sex and gender. CPGs developed under the lens of a more sensitive gender approach formulated relevant Patient, Intervention, Comparison, Outcomes (PICO) questions and showed a greater diversity of situations, detailing different types of patients. Even though some CPGs do express good intentions regarding gender mainstreaming – for example, using gendered language and a balanced developers’ group – important omissions and a lack of precise information were still found.