The authors present sobering findings of a study about women and leadership in higher education. The findings of the authors' study are based on the experiences of a small group of women faculty at Johns Hopkins University. The study found that, despite good intentions and occasional interventions by leaders in higher education, women are still underrepresented in academic leadership positions, both absolutely and relative to the eligible pool of tenured women. This finding has been documented extensively in the literature on academic leadership, by the National Institutes of Health (NIH) and by many academic institutions that have undertaken self-evaluations (a list of these institutions and links to their self-evaluations are available at www.biostat.jhsph.edu/~fdominic/NIHwomen/other.html). Department chairs and academic deans can be key agents of change in efforts to diversify the academy, encouraging new approaches to recruitment and equity in promotion and tenure. However, women are even less well represented among academic deans and department chairs than among full professors, raising questions about the root causes for the persistence of gender inequity at the highest ranks of academic leadership. It appears that the problems stem not from the pipeline to leadership positions for women but rather from the characteristics of high-level administrative jobs, the lack of reward and recognition in those jobs, and the essentially sexist nature of informal networking in higher education administration. (Contains 1 note.)