Surgical operations constitute an integral part of medical management of different health challenges. Developing countries suffer from under-reporting of health conditions even when such conditions are fairly common in occurrence. This study observed common surgical cases with a view to highlighting possible associations with gender. A retrospective cross-sectional descriptive approach was adopted. A total of 626 cases presenting for surgical review between a two-year periods from September 2020 to August 2022 at University of Calabar Teaching Hospital, Calabar in Nigeria were reviewed. Data analysis to test for gender association was carried out using chi-square analysis on SPSS 22.0 at 95% confidence level with p-value of ≤ 0.05. The highest frequency of 56% was recorded for breast tumour. This was followed by hernia and goitre which accounted for 20% and 15 of surgical cases respectively. Lesser frequencies were observed for lipoma (4%), appendicitis (2%) and fistula (2%). The least among the commonly observed cases was testicular torsion which was recorded to be 1%. Breast tumour and goitre were significantly higher in females compared to males, while hernia was seen to be significantly higher in males compared to females. Testicular torsion occurred solely in males. This study concludes that significant gender associations exist in the distribution of surgical cases at the study centre. While female preponderance was observed for breast tumour and goitre cases, hernia was prevalent among the males.