Background/Aim: An increasing number of patients undergo surgical treatment for metastatic spinal cord compression (MSCC). However, the possible role of sex as an independent predictor of long-term survival has not been studied. This study aimed to examine whether sex is associated with long-term survival after surgical treatment in patients with MSCC. Patients and Methods: A total of 110 patients were operated on for MSCC from 2005 through 2006. The relation between sex and overall survival was investigated. The followup period was 10 years. Results: Survival time was significantly longer for women compared to men (mean±SD: 29±5.2 vs. 14±3.6 month (p=0.01). With adjusted analysis, this difference remained statistically significant. After adjusting for specific primary tumor type and time since surgery, the hazardratio of 10-year survival for men compared to women was 1.47 (95% confidence intervaI=1. 01-2.18, p=0.048). Conclusion: These findings indicate that sex is associated with long-term survival in patients treated for MSCC.