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INTRODUCTION Acromegaly is a chronic, slowly progressive disorder caused mostly by growth hormone (GH) -producing pituitary neuroendocrine tumors (PitNETs). Recently, the association between gender and age at the time of diagnosis and the course of acromegaly has been a focus of debate. OBJECTIVES The aim of our study was to evaluate the association of sex and age and the clinical features, biochemical status, severity of disease, and comorbidities. PATIENTS AND METHODS This was a single-center study, conducted in a group of consecutive patients with acromegaly and no family history of PitNETs. RESULTS Our study included 101 patients (60 females/41 males) who were eligible for the study. The mean age at the time of diagnosis was 47.3 (14.1) years and median diagnostic delay was 5 (3;10) years. Age at the time of diagnosis and diagnostic delay were not statistically different in males and females. Levels of IGF-1 above the upper limit of age-adjusted normal range (%ULN IGF-1) were greater in males than in females; 174.8 (98.9) % vs 109.4 (66.6) %, P = 0.002, while no statistical significance between age groups was found. Median basal and nadir GH levels did not differ between sexes. Males presented with hypogonadism more frequently than females (54% vs 26%, P = 0.005). Hyperprolactinemia, hypogonadism, and macroadenoma were more frequently observed in younger patients (≤40 years) than middle-aged (41-59 years) and elderly patients (≥60 years)(P <0.05). CONCLUSIONS According to our results, hypogonadism and greater IGF-1 values are more frequently observed in males. Hyperprolactinemia, hypogonadism and macroadenoma are more frequent in younger patients.