Objective(s)To describe how medical school rank may be associated with matriculation into otolaryngology residency programs.MethodsA list of medical students who matched into otolaryngology residencies in 2020, 2021, and 2022 was obtained from Otomatch (Otomatch.com). For each student, their medical school, U.S. News & World Report Best Medical School (Research) ranking, and region based on the U.S. Census divisions were recorded. The medical schools were divided into four Tiers according to rank: 1–40 (Tier 1), 41–80 (Tier 2), 81–124 (Tier 3), and 125–191 (Tier 4). Residency programs were also grouped by region, whether they were large (>3 residents/year) or small (<3 residents/year), and their Doximity reputation ranking: 1–31 (Tier 1), 32–61 (Tier 2), 62–91 (Tier 3), and 92–125 (Tier 4).ResultsNine hundred and ninety‐five medical students were included in this study. The majority of residency matriculants were MDs (N = 988, 99.3%) who came from Tier 1 (N = 410, 41.2%) or Tier 2 (N = 313, 31.5%) medical schools. Those who attended higher‐tier medical schools were more likely to match into higher‐tier residency programs (p < 0.001). 57.8% (N = 237) of the applicants who attended Tier 1 medical schools matriculated into a Tier 1 residency program, whereas only 24.7% (N = 42) of the applicants from Tier 4 medical schools matriculated into a Tier 1 residency program.ConclusionApplicants who attend top‐tier medical schools represent significantly more residents at top‐tier otolaryngology residency programs than those from lower tier medial schools.Level of EvidenceNA Laryngoscope, 2023