ObjectivesFemale otolaryngologist‐head and neck surgeons (OHNS) confront unique barriers. This study examines the influence of home life, especially gendered division of household labor, on leadership, productivity, and burnout.MethodsA survey was distributed through social media and national society list‐serv. Demographics, responsibility for household roles, and Maslach Burnout Inventory for Medical Personnel were included. Participants were invited to participate in semi‐structured interviews, employing purposive sampling, with qualitative thematic analysis.ResultsResponse rate was 26.4% (145 of 550 of eligible participants; 38.7% women, 60.7% men). Significantly fewer women were married (64.3% vs. 92% of men, p < 0.001), and significantly more were childless (21.4% of women vs. 9.1% of men, p = 0.037). More men reported exclusive/major responsibility for five duties, including yard work and home maintenance (all p < 0.03). More women reported exclusive/major responsibility for 15 duties, including meal planning and coordinating childcare (all p < 0.03). Women had higher Emotional Exhaustion on univariate analysis (p = 0.015). Across 27 interviews, two main themes were identified, each with three associated subthemes: Theme one, “division of duties,” with subthemes (1) the way household duties were divided, (2) traditional gender norms, and 3. changing duties over time/unexpected circumstances. Theme two, “impact of domestic duties,” with subthemes (1) professional, (2) financial, and (3) burnout/life satisfaction.ConclusionsWomen OHNS disproportionately manage domestic responsibilities, possibly altering career trajectory for some OHNS. Burnout, especially emotional exhaustion, may be elevated due to inequitable labor. Future research should focus on identifying ways to improve equity for this group.Level of EvidenceN/A Laryngoscope, 2024