BACKGROUND Few findings in the literature have been as widely studied and consistently verified as the higher prevalence of depression among women. However, doubts remain on the distinguishing features of female depression. The available studies concur in the higher prevalence of somatizations among women and in the possibility that the impact of these symptoms on quality of life could be underestimated. In this study, all these aspects were analyzed in a sample of depressive patients. METHODS We performed an epidemiologic, cross-sectional, non-intervention study. The final sample of 1164 patients with major depressive disorder (DSM-VI) (629 women and 535 men) was recruited in outpatient Mental Health Services in Spain. Assessments were performed using the Hamilton (HAM-D17), the Quality of Life for Depression Scale (QLDS) and the Patient Health Questionnaire 15-Item Somatic Symptom Severity Scale (PHQ-15) to measure somatic symptoms. Differences were analyzed by Chi-square and ANOVA or Student's t-test, depending on the variable. CONCLUSIONS Somatic symptoms were significantly more prevalent among women. A positive correlation was found between somatic symptoms and worse quality of life. Clinical variables measured by the Hamilton scale showed significant differences in some items but no strong conclusions could be drawn. These results suggest gender differences in depression, which should be replicated in other samples. Other risk or clinical factors could also be included.