In semi-arid Sub-Saharan Africa, groundwater is a critical resource for rural livelihoods given the pressures on surface water and lack of piped delivery. Socially defined gen- der roles in water management often create disparities and inequalities regarding water access, use, and labour, making consideration of gender issues an important component of groundwater governance. Resources shared across borders raises the question about the relevance of and approach to gender in transboundary ground- water governance. This paper explores this question in light of the lack of gender responsive governance arrangements over transboundary groundwater resources. It uses qualitative methodologies to examine the need for institutional approaches to improve gender sensitivity and equality in transboundary groundwater cooperation. The paper seeks to assess how legal instruments on gender and transboundary water resources influence equality for women and men in terms of: reach of water access, benefits of water use, and empowerment. First, it analyses the level of gender sensi- tivity in international and regional instruments that provide the governance frame- work for transboundary groundwater. It then proposes a new integrated framework for analysis, which it applies to the case study of the Ramotswa aquifer – a resource shared between South Africa and Botswana. The paper examines the extent to which international instruments, national law and local programmes and projects related to transboundary groundwater governance correspond with the realities on the ground. The results uncover constraints in both countries regarding equal participation in decision-making, deficiencies in meeting gendered needs and ensuring benefits, and disempowering legal frameworks. The paper concludes with entry points that link transboundary water governance and local level water management, offering potential indicators that can inform governance and programming, and enable improved moni- toring of the implementation of gender responsiveness at multiple levels.