Research on child survival and health has indicated disparities between boys and girls in selected Middle Eastern countries. Health disparities in later life are understudied in this region. In this article, we examine differences between women and men in later-life activity limitation in Egypt and Tunisia. Difficulty executing physical tasks is more common for women than for men in both study sites, although differences are smaller after adjustment for underlying illness. Differences in the difficulty of executing physical tasks also are sensitive to environmental controls in variable ways across the study sites. The findings caution against the sole use of reported disability in comparative studies of gender and aging.