Dating back to the case of Phineas Gage, decades of neuropsychological research have shown that the ventromedial prefrontal cortex (vmPFC) is crucial to both real-world social functioning and abstract decision-making in the laboratory (e.g., Bechara et al., 1994; Damasio et al., 1994; Stuss et al., 1983). Previous research has found that the relationship between the laterality of individuals’ vmPFC lesions and neuropsychological performance is moderated by their sex, whereby there are more severe social, emotional, and decision-making impairments in men with right-sided vmPFC lesions and in women with left-sided vmPFC lesions (Tranel et al., 2005; Sutterer et al., 2015). We conducted a selective review of studies examining the effect of vmPFC lesions on emotion and decision-making, and found further evidence of sex-related differences in the lateralization of function not only in the vmPFC, but also in other neurological structures associated with decision-making and emotion. Our review suggests that both sex and laterality effects warrant more careful consideration in the scientific literature.