Occupational gender segregation is a strong feature of the US labor market. While some occupations have become increasingly integrated over time, others remain highly dominated by either men or women. Our analysis of trends in overall gender segregation shows that, after a considerable move towards more integrated occupations in the 1970s and 1980s, progress has completely stalled since the mid 1990s. Occupational segregation is a concern to policy makers for two reasons: it is inefficient economically, preventing able people from moving into occupations where they could perform well and that would satisfy them more than the ones open to them. And occupational segregation is a major cause for the persistent wage gap. Our analysis confirms that average earnings tend to be lower the higher the percentage of female workers in an occupation, and that this relationship is strongest for the most highly skilled occupations, such as medicine or law. Yet this is also a strong feature of jobs requiring little formal education and experience, increasing the likelihood of very low earnings for women working in female-dominated, low-skilled occupations such as childcare.