Ever since President Trump shocked the Swiss with a 39 percent tariff, one of the highest rates the world, the big question in Zurich, Geneva, Basel and across Switzerland is: Why us?

Known for its political neutrality, high-end watches and cutting-edge pharmaceuticals, Switzerland has long prized what it describes as an “excellent” relationship with America. But as Mr. Trump upends the global trading order, he has singled out countries that he says treat Americans “unfairly” by exporting more goods to the United States than they buy from it.

America’s trade deficit in goods with Switzerland was just over $38 billion last year. In the first six months of this year, the deficit ballooned to nearly $48 billion, for one main reason (more on that below).

Mr. Trump has railed against the deficit with Switzerland publicly and behind closed doors. In a phone call last week with the Swiss president, Karin Keller-Sutter, Mr. Trump stressed that the country had not done enough to address the deficit.

Since then, the Swiss have pushed for continued talks with the Trump administration and are devising a more attractive offer to persuade Mr. Trump to reduce tariffs on Swiss goods.

What’s driving the U.S. trade deficit with Switzerland?

Swiss exports to the United States are dominated by a handful of industries.

The most distinctive is gold refining. In recent months, two-thirds of Switzerland’s exports to the United States were accounted for by various forms of gold. These bars of gold are often sent from London, a trading hub, to Switzerland, a refining hub, where the metal is forged into bars sized for the standards required by U.S. warehouses and then shipped across the Atlantic.

Surging demand for gold in the United States as Mr. Trump threatened to upend the global trading order fueled a spike in Swiss gold imports — and greatly expanded the U.S. trade deficit with Switzerland.

Excluding gold, Switzerland’s mammoth pharmaceutical industry accounts for half the value of Swiss products shipped to America. In 2024, Swiss drug companies, which include the pharma giants Roche and Novartis, exported around $35 billion worth of medicines, cancer treatments, vaccines and other drugs, according to the U.N. Comtrade database.

Mr. Trump is threatening to set a high tariff on the global pharmaceutical sector unless drugmakers slash their U.S. prices and move production to America. Mr. Trump said that he told Ms. Keller-Sutter during their call that Switzerland makes “a fortune with pharmaceuticals.”

Switzerland also exports precision machinery, which includes things like cutting tools — American manufacturers use them to trim car or computer parts — and specialty drills for airplane parts or industrial machines. These companies sold about $12 billion in goods to America last year, according to the industry’s trade group. The group recently warned member companies that they face a “horror scenario” because of the U.S. tariffs.

Switzerland’s famed watch industry, dominated by luxury players like Rolex, Breitling and Patek Philippe, as well as conglomerates like the Swatch Group and Richemont, makes up about 4 percent of Swiss goods send to the United States. Swiss watch exports to the United States were worth more than $5 billion last year, according to the Federation of the Swiss Watch Industry.

Swiss chocolates and cheese, as well as Nespresso coffee pods, are also popular in America.

What was the U.S.-Switzerland bond like before the trade turmoil?

Officials on both sides often speak of a special relationship, and the U.S. Treasury secretary, Scott Bessent, recently called Switzerland “a sister republic.” But in reality, ties in recent years have been marked “more by friction than affection,” said Martin Gutmann, a Swiss American historian who teaches at the Lucerne School of Business.

More recently, the disagreements between the two nations have to do with the diverging views on Switzerland’s contributions to the U.S. economy. After Mr. Trump initially threated to impose a 31 percent tariff on Switzerland in April, Swiss officials presented a number of arguments in hopes of persuading U.S. trade negotiators of lowering that rate, which had also come as a surprise. They thought then that they had come to an agreement that Mr. Trump would approve.

The United States has also been frustrated that Switzerland has been slow to adopt sanctions against Russia, and in WikiLeaks cables, U.S. diplomats have described the Swiss as difficult to deal with. Aside from these incidents, the two countries have had longstanding disputes over banking secrecy enshrined in Swiss law and previous U.S. tax-evasion investigations into the Swiss bank UBS, Mr. Gutmann said.

Is there anything the Swiss can do?

As Switzerland continues to negotiate with the administration, it has options that may appease Mr. Trump. Switzerland could do what other countries that received lower tariff rates have done: offer to invest billions of dollars in manufacturing and energy — in some cases repackaging previously announced investment plans as new ones.

Swiss officials plan to offer a menu of targeted investments. Swiss pharma giants have already announced billions of investments in the United States, including a $50 billion pledge by Roche for research and development and manufacturing sites, and a $23 billion promise from Novartis for investments over five years.

The Swiss may also dangle commitments to military spending on top of a deal in 2021 to buy 36 F-35 American fighter jets and the Patriot missile system. Officials hinted that the country was looking into importing more liquefied natural gas from America. And they could consider cutting their exports of gold.

Switzerland’s economy minister, Guy Parmelin, said that the country had been “especially mistreated,” but that the government would work to understand “what went wrong, what exactly the United States and Donald Trump want, and to see if there is room for maneuver.”

He also suggested that Swiss executives close to Mr. Trump — whom the Swiss press call the “Mar-a-Lago Crew” — be deployed to use their connections.