Publication of your research represents the culmination of your scientific activities. The key to getting manuscripts accepted is to make them understandable and informative so that your colleagues will read and benefit from them. We describe key criteria for acceptance of manuscripts and outline a multi-step process for writing the manuscript. The likelihood that a manuscript will be accepted by a major journal is significantly increased if the manuscript is written in polished and fluent scientific English. Although scientific quality is the most important consideration, clear and concise writing often makes the difference between acceptance and rejection. As with any skill, efficient writing of high-quality manuscripts comes with experience and repetition. It is very uncommon for a manuscript to be accepted as submitted to a journal. Thoughtful and respectful responses to the journal reviewers' comments are critical. Success in scientific writing, as in surgery, is dependent on effort, repetition, and commitment. The transfer of knowledge through a well-written publication in a high-quality medical journal will have an impact not only in your own institution and country, but also throughout the world.Publication of a scientific manuscript is the ultimate and arguably one of the most important components of research.1 Through publication of a scientific manuscript, your knowledge and experience become citable science in the form of novel information transmitted to physicians and scientists for current and future generations. Writing manuscripts can be a rewarding and satisfying creative process, and publication of manuscripts confers substantial benefits to academic surgeons.3 Publications in high-quality journals lend credibility to your research (due to the rigorous peer review of high-quality journals and the intense competition for the limited publication space in such journals) and are highly valued evidence of scholarship by promotion and tenure committees. A strong track record of publications carries significant influence in the allocation of grants.For trainees and surgeons early in their careers, writing manuscripts can be a valuable learning experience. As with any skill, efficient writing of high-quality manuscripts comes with experience and repetition. In this article, we offer suggestions to speed the learning process for trainees and early-career surgeons. This advice is relevant not only for manuscripts submitted to Annals of Surgical Oncology, for which most of us serve as editorial leaders, but also for clinical research manuscripts in general.