Introduction: This research compares the patterns of hand injuries, treatments and outcomes between male and female Australian rules football players. Methods: This retrospective cohort study reviewed Australian rules football players treated for surgically operable hand injuries at Frankston Hospital in Melbourne, Australia, between January 2021 and August 2024. Data collected included demographics, injury mechanisms, types of fractures or dislocations, treatment methods and postoperative complications. Results: Among 46 Australian rules football players (36 males, 10 females) in this cohort study, notable gender differences in injury patterns were identified. Males predominantly sustained axial loading fractures (30.6%), whereas females more often experienced hyperextension injuries (30.0%) and trampling injuries (20.0%). Both genders primarily underwent open reduction and internal fixation (55.6% males, 60.0% females). Complication rates were low (5.6% males, 10.0% females), but recovery times were generally longer for females. Conclusions: The study highlights distinct injury patterns and outcomes by gender, suggesting physiological and anatomical differences may influence injury susceptibility and recovery in Australian rules football players. These findings underscore the importance of gender-specific prevention and rehabilitation strategies to enhance player safety, recovery and performance.