This paper explores the inter-linkages of gender, energy use, health and hardships in the Himalayan State of Himachal Pradesh in India. It brings out a gender-differentiated and age-differentiated picture of hardships and health impact on the use of traditional biofuels. The study is based on survey with questionnaires covering 4296 individuals, 729 households, 84 villages and 9 districts where biomass fuels meet 70% of household fuel needs. On an average, women walk 30 km each month taking 2.7 h per trip for fuel wood collection over hilly terrain, often at high altitudes and undergo stress like stiff-neck, backache, headache and loss of work days. Girls below 5 and females in 30-60 age-groups have higher proportion of respiratory symptoms than males of similar age-groups. While many studies are done on the health impact of cooking fuels, very little quantitative work is done on the other aspects of the fuel chain viz, collection, transportation and processing of fuels. Such studies would guide energy policy and health policy to improve the lives of women. (C) 2011 Elsevier Ltd. All rights reserved.