Although the gender gap in math course-taking and performance has narrowed in recent decades, females continue to be underrepresented in math-intensive fields of Science, Technology, Engineering, and Mathematics (STEM). Career pathways encompass the ability to pursue a career as well as the motivation to employ that ability. Individual differences in cognitive capacity and motivation are also influenced by broader sociocultural factors. After reviewing research from the fields of psychology, sociology, economics, and education over the past 30 years, we summarize six explanations for US women's underrepresentation in math-intensive STEM fields: (a) cognitive ability, (b) relative cognitive strengths, (c) occupational interests or preferences, (d) lifestyle values or work-family balance preferences, (e) field-specific ability beliefs, and (f) gender-related stereotypes and biases. We then describe the potential biological and sociocultural explanations for observed gender differences on cognitive and motivational factors and demonstrate the developmental period(s) during which each factor becomes most relevant. We then propose evidence-based recommendations for policy and practice to improve STEM diversity and recommendations for future research directions.