Men and women may use alcohol to regulate emotions differently, with corresponding differences in neural responses. We explored how the viewing of different types of emotionally salient stimuli impacted brain activity observed through functional magnetic resonance imaging (fMRI) from 42 long-term abstinent alcoholic (25 women) and 46 nonalcoholic (24 women) participants. Analyses revealed blunted brain responsivity in alcoholic compared to nonalcoholic groups, as well as gender differences in those activation patterns. Brain activation in alcoholic men (ALC.sub.M) was significantly lower than in nonalcoholic men (NC.sub.M) in regions including rostral middle and superior frontal cortex, precentral gyrus, and inferior parietal cortex, whereas activation was higher in alcoholic women (ALC.sub.W) than in nonalcoholic women (NC.sub.W) in superior frontal and supramarginal cortical regions. The reduced brain reactivity of ALC.sub.M, and increases for ALC.sub.W, highlighted divergent brain regions and gender effects, suggesting possible differences in the underlying basis for development of alcohol use disorders. eLife digest More than 100 million people worldwide are thought to have alcohol use disorder, also known as AUD, alcohol dependence or alcoholism. People who struggle to regulate their emotions tend to consume more alcohol than others. This suggests that impaired emotion processing may increase the risk of developing the disorder. Most studies of emotion processing in people with alcohol use disorder do not distinguish between men and women. But evidence suggests that men and women process emotions in different ways. Sawyer et al. set out to explore the possible relationships between emotion processing, gender and alcoholism. Four groups of volunteers took part in the study: abstinent men and women with the disorder, and control groups of men and women without a history of alcoholism. Each group contained between 15 and 21 participants. The two abstinent alcoholic groups had not consumed alcohol for at least 21 days. The average length of abstinence was 7 years. The volunteers viewed a mixture of emotionally charged and neutral images while lying inside a brain scanner. The emotionally charged images were of happy, erotic, gruesome or aversive scenes. Sawyer et al. measured the difference in brain responses to the emotionally charged images versus the neutral ones, and compared this measure across the four groups of participants. Abstinent alcoholic men showed muted brain responses to the emotionally charged images compared to their female counterparts. This effect was seen in brain regions involved in memory, emotion processing and social processing. The same pattern occurred for all four types of emotionally charged image. Abstinent alcoholic men also showed smaller brain responses to the emotionally charged images than non-alcoholic control men. By contrast, abstinent alcoholic women showed larger brain responses to the emotionally charged images than non-alcoholic control women. This suggests that abstinent alcoholic men and women differ in the way they process emotions. Future studies should investigate whether these differences emerge over the course of abstinence. They should also examine whether these differences might contribute to, or result from, differences in alcohol use disorder between men and women.