To characterize recent trends in compensation among academic urologists, evaluate gender-based pay disparities, and project cumulative career earnings.

Compensation data were obtained from the American Association of Medical Colleges Faculty Salary Surveys for 2016-2024. Median compensation was stratified by year, gender, and academic rank. Compensation growth was assessed using compound annual growth rates and forward projected to estimate time to reach pay parity. Cumulative career earnings were estimated using net present value analysis.

Between 2016 and 2024, median compensation grew by 5.83% for instructors, 3.33% for assistant professors, 2.93% for associate professors, 3.06% for professors, 1.70% for chiefs, and 3.31% for chairs. Inflation growth was 3.29%. Female assistant, associate, and full professors were compensated less than men over the study period. In 2024, women comprised 30.1% of assistant, 22.3% of associate, and 9.6% of full professors; for every $1.00 earned by men, women earned $0.93, $0.86, and $0.93, respectively. With a 30-year career and 8-year promotion intervals, women had a cumulative earnings deficit of $940,000. Assuming trends persist, parity was projected at 43.8 years for assistant, 13.3 years for associate, and not within 50 years for full professors.

Academic urologist compensation tracked near or below inflation for most ranks. Women consistently received lower compensation relative to men, particularly at the associate level. The projected career earnings gap of almost $1 million may underestimate the true disparity, given evidence of slower promotion among female academic urologists. Policies that ensure equitable pay and career progression opportunities remain critical.