The purpose of this study was to quantify gender diversity in leadership positions within the field of medical physics, as well as within award categories and other recognitions by the American Association of Physicists in Medicine. The April 2019 PDF version of the AAPM membership directory was searched for all users self-reporting as holding a leadership position at their place of employment, those elected to leadership positions within the AAPM, those serving as chair of an AAPM council, and those listed as having received an award or other such recognition from AAPM (beginning in 1972 with the William D. Coolidge Award). Historical data for these categories were obtained from archived membership directories on the AAPM website. The AAPM website was also used to identify members who have served on the Medical Physics Editorial Board. The Commission on Accreditation of Medical Physics Education Programs (CAMPEP) website was used to identify the current directors of graduate and residency programs (as of July 2019). Because gender was not a reported field in any of these categories, gender was assigned by reviewing names and photographs. Percentage representation in these respects was compared to the overall percentage of women in the AAPM in 2019 (23.3%) and reported the number of women working as medical physicists globally (29.8%). Within the AAPM, the percentage of women reporting clinical leadership roles is 12.0% within the US, 13.6% in Canada, and 18.0% in all other countries combined. Women comprise only 7.5% of CAMPEP graduate program directors and 21.5% of residency program directors. The percentage of female presidents in AAPM is 8.1%. A woman has never served as Editor-in-Chief of Medical Physics, and the average for the past 10 yr for female board membership is 13.6%. With the exception of the John R. Cameron Young Investigators Symposium Award, the percentage of all female AAPM awardees is less than the percentage of women AAPM members. The lowest percentage of female representation within AAPM is among council chairs with only one woman having held a chair position out of 42 positions (2.4%) from 1970 to July 2019. Similar to the traditional discipline of physics, medical physics displays a clear gender disparity with regard to leadership positions, both within educational training programs and the AAPM. Further investigation into the demographics of the field and psychosocial factors affecting medical physicists may help to elucidate the origin of these disparities and inform strategies to address them.