The purpose of this study was to determine the relative impact of gender and age on the development of contrast-induced acute kidney injury (CIAKI) after cardiac catheterization. CIAKI is a recognized complication of coronary angiography, but the relative impact of age strata and gender is not well understood. We prospectively enrolled 21,489 consecutive patients undergoing coronary angiography and stratified patients by age and gender into 4 age categories (<50, 51 to 64, 65 to 79, and >80 years). Of those 21,489 patients, 13,127 were included in the study. Men and women were compared within each age category for the development of CIAKI in the period after angiography. The incidence of postprocedural CIAKI and mortality rates among groups were compared. Rates of postcatheterization CIAKI were higher for women compared with men in the 65- to 79-year-old (14.5% vs 11.0%, p <0.001) and >80-year-old (18.7% vs 15.1%, p = 0.048) groups, but no differences were seen in the younger cohorts. In conclusion, geriatric women are at greatest risk for the development of CIAKI after angiography.