Up to four times as many females as males may have been killed in the tsunami. This review of the evidence available in Aceh (Indonesia), India and Sri Lanka reveals that more women appear to have been killed by the tsunami for a variety of reasons. These include women staying behind to look for their children and women being less likely to know how to swim or climb palm trees. In Aceh women have a high level of participation in the labour force, but the wave struck on a Sunday when they were at home and the men were out running errands, or were out at sea (where the waves were less ferocious) or working in the fields. Women in India were close to the shore, waiting for the fishermen to come in with their catch. In Sri Lanka in Batticoloa District it was the hour women on the east coast usually took their baths in the sea. Women have also been hit heavily by the after-effects of the tsunami. There is evidence of women experiencing verbal, physical and sexual harassment by men in camps, and women in particular being hit by the loss of income and inability to access cash, with some women at risk of sexual exploitation. Recommendations are made for governments, donors and NGOs.