To understand divergent and remarkable lives lived, we examined the accomplishments, family dynamics, life orientation, psychological well-being, and definition of a meaningful life among two exceptional groups at age 50: Top Science, Technology, Engineering, & Mathematics (STEM) doctoral students (270 males, 255 females, originally surveyed in their mid-20s) and profoundly gifted adolescents (263 males, 71 females, top 0.01% in ability, first studied at age 12). The creativity and occupational stature of both cohorts were extraordinary and commensurate. Life priorities, time allocation, and breadth of interests created paths that differed for women and men, resulting in contrasting, but equally exceptional, life outcomes across career, life, and relationship satisfaction. Distinct constellations of personal attributes of intellectually and scientifically brilliant women, relative to such men, operated to form satisfying and productive lives that differed for the women and men as a whole. Findings cast light on the participation of women and men in STEM and conceptually demanding leadership positions.