Tamoxifen　(TAM),　a　selective　estrogen　receptor　(ER)　modulator,　has　received　approval　for　use　in　patients　with　breast　cancer　(BC)　exhibiting　positive　ER　expression.　Given　the　widespread　clinical　use　of　TAM,　a　comprehensive　real-world　study　of　its　adverse　events　(AEs)　is　warranted.　The　database　for　analysis,　sourced　from　the　Food　and　Drug　Administration　Adverse　Event　Reporting　System　(FAERS),　covers　the　period　from　the　first　quarter　of　2014　to　the　third　quarter　of　2023.　A　disproportionality　analysis　was　conducted　to　quantify　the　correlation　between　TAM　and　AEs.　Subgroup　analyses　were　performed　to　identify　differences　between　BC　AEs　in　males　and　females　receiving　TAM,　aiming　to　assess　the　risk　factors　of　male　BC　AEs.　Total　4890　reports　indicated　BC,　with　91　and　4190　specifically　linked　to　AEs　in　male　and　female　patients　with　BC,　respectively.　Male-specific　AE　was　libido　decreased　(reporting　odds　ratio　[ROR]:　43.33),　and　female-specific　AE　was　uterine　disease,　including　sarcoma　uterus　(ROR:　519.51),　endometrial　cancer　(ROR:　131.26),　uterine　polyp　(ROR:　40.83),　endometriosis　(ROR:　11.39),　among　others.　A　notably　higher　risk　of　AEs　in　male　patients　with　BC　was　observed　in　individuals　aged　＞65　years　(chi(2)　=　20.83,　p　＜　.001).　Male　patients　with　BC　had　a　relatively　higher　risk　of　hospitalization　(chi(2)　=　4.83,　p　=　.03)　and　a　lower　risk　of　deaths　(chi(2)　=　5.32,　p　=　.02).　Theses　finding　may　assist　healthcare　professionals　in　recognizing　the　TAM-associated　AEs　and　understanding　gender　differences,　potentially　improving　safety　in　clinical　applications.