Background : At present, more and more clinicians in China are partaking in case discussions using WeChat groups for the purposes of communication, diagnosis, treatment planning, and information sharing. However, the reliability of discussions using WeChat groups remains debatable. This study aimed to analyze case discussions in WeChat groups and evaluate their significance. Methods : By taking screenshots of the chat records from the most-used WeChat groups by orthopedic surgeons, all of the data related to the cases were collected from June to August in 2019. We analyzed the purpose, participation, and completeness of each case. Furthermore, we analyzed whether the conclusion reached in each case discussion, which was supported by the majority of members, was consistent with the opinion of three experts after evaluating all of the data from the case records. Results : Seven WeChat groups and 60 cases were included. WeChat group members often discussed cases to show surgical results (40.0%), to obtain treatment advice (39.0%), and to seek diagnostic advice (9%). The rate of ‘likes’ for ‘surgical results show’ was greater than the rate of ‘likes’ for alternative purposes (P<0.05). The percentage of complete, relatively complete and incomplete cases was 23%, 32%, and 45%, respectively. The relatively complete cases received more effective comments than the other cases (P<0.05). The cases for diagnostic purposes were more complete than those for other purposes (P<0.05). Among 60 cases, only 29 cases led to the same conclusions being reached among the three experts and WeChat group members. The consistency rate of conclusions relating to treatment was higher than that associated with the other purposes (P<0.05). The consistency rate of the complete cases was higher than that of the relatively complete and incomplete cases (P<0.05). Conclusions : Clinicians should treat discussions in WeChat groups for clinical decision-making with caution. Online discussions using WeChat groups should be standardized in respect to the cases presented and the comments that are generated.