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Recently, sex\u2014as a biological variable\u2014has received attention for its clear implications in differences in injury pathophysiology, diagnosis, and management. Due to historical, social, and gender biases, females have been excluded from physiology-based research and clinical trials, resulting in limited insight into female physiology and poor translation of current diagnostics and therapies to females. The role of sex-specific hormones has been implicated in a host of sex differences following cerebrovascular injury and the ensuing clinical outcomes. Therefore, this review aims to provide a contemporary overview on the role of biological sex and sex hormones in the underlying physiology, mechanisms, and outcomes of selected cerebrovascular injuries. First, we identify sex-based differences in clinical outcomes in ischemic stroke, ICH, aSAH, HIBI, and TBI. Second, we discuss the impact of biological sex and sex hormones on the fundamentals of cerebrovascular physiology. 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