Objective: To examine female author representation within publications in the field of urology from the United States from 2000-2019. Methods: All 25,787 articles with a U.S. correspondence address published in the two largest U.S. headquartered general urology journals, Urology and Journal of Urology, were analyzed from 2000-2019. Gender was assigned to each first and last author based on the author's first name. First names were matched to a database of U.S. Social Security Administration data to determine gender. Results: Overall female authorship, female senior authorship, and female first authorship exhibited a significant upward trend from 2000 to 2019 (P <0.001, P <0.001, P = 0.002). As the number of female last authors increased, female last authors were significantly more likely to publish with female first authors, and significantly less likely publish with male first authors (P <0.001, P <0.001). Furthermore, we found a significant difference for female authors being less likely to get cited than male authors (p = 0.02), despite the greater proportion of females that authored research articles with higher citation counts compared to males (P <0.05). Conclusion: Despite the significant progress in female representation within urological publications, female-authored publications continue to constitute a smaller proportion of the urological literature and are less likely to be cited. Our study provides the first evidence on the current status of female underrepresentation within academic urology and literature productivity at this watershed moment. As the number of female urologists evolves, these findings will be of significant impact in the advancement of female investigators in urology.