ObjectivesSocial media has enabled discussion of relevant topics within otolaryngology. With increasing academic discourse occurring on virtual platforms, it is important to examine who is influencing these discussions. This study thus aims to: (1) identify the top Twitter influencers in otolaryngology and (2) assess the relationship between Twitter influence and academic impact.Study DesignCross‐sectional analysis.SettingTwitter.MethodsThe Right Relevance program was used to identify and rank the top 75 Twitter influencers, excluding organizations, according to the search terms “otolaryngology,” “head and neck surgery,” “ear nose throat,” “rhinology,” “head and neck,” “laryngology,” “facial plastics,” and “otology.” Demographic data and h‐index were collected for each influencer. Correlational analyzes were performed to assess the relationships between Twitter rank and geographic location, sex, subspecialty, and h‐index.ResultsThe majority of the top 75 influencers were otolaryngologists (87%), female (68%), and located in the United States (61%). General otolaryngology (n = 20, 31%) was more well‐represented than any individual subspecialty including facial plastics (n = 10, 15%), rhinology (n = 10, 15%), and neurotology (n = 9, 14%). There was a significant relationship between Twitter rank and h‐index (Spearman ρ value of –0.32; 95% confidence interval: –0.51 to –0.01; P = .006). Twitter rank was not significantly correlated with subspecialty, sex, or geographic location (P > .05).ConclusionThe majority of Twitter influencers within otolaryngology were otolaryngologists, female, and located in the United States. Social media influence is positively associated with academic impact among otolaryngologists.