Background: Gender differences in anti-doping rule violations (ADRVs) have been noted in international research, yet systematic analyses are rare. This study addresses that gap by providing the first comprehensive evaluation of the doping prevalence by gender in Serbia. Methods: A 19-year retrospective quantitative analysis was conducted on data collected by the Anti-Doping Agency of Serbia (ADAS) between 2006 and 2024. In total, 14,919 doping controls were performed, including 10,912 (73.11%) on male athletes and 4007 (26.89%) on female athletes. Results: Across this period, 146 ADRVs were identified, with a clear gender imbalance: 128 (87.32%) cases involved male athletes and 18 (12.68%) female athletes. A Chi-Square test confirmed a significant association between gender and ADRVs, Chi2(1, N = 14,919) = 15.11, p < 0.001, indicating that male athletes were more likely to violate anti-doping rules. Substance profiles also differed: anabolic agents (S1) dominated overall, while stimulants (S6) and cannabinoids (S8) were more frequent in males, and diuretics (S5) and hormone modulators (S4) in females. Conclusions: These findings reveal a pronounced gender disparity in doping behavior and substance choice, providing a foundation for further research and emphasizing the need for gender-sensitive anti-doping education and policy.
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