In assuming the mantle of state power—becoming the state—women confront the same challenges as their male counterparts—political intrigues, partisan wrangling, struggles for power, constitutional constraints, complex policy problems, economic crises, international alliances, national security, natural disasters, and partial knowledge. This chapter explores those challenges and the women who succeed in undertaking them. It deals with biographical sketches of some women who have won the highest elected office in their nations and are serving as presidents or prime ministers in various regions of the world in the twenty-first century. The chapter explores the use of gender quotas as a means to increase the numbers of women in elective offices, contrasting the strengths and limitations of reserved seats, voluntary quotas, and mandatory quotas. It focuses on the intensive political work involved in crafting a "women's agenda" and forging support within and beyond governing institutions for specific issue priorities and policies.