BackgroundSocial media amplifies the accessibility, reach and impact of medical education and conferences alike. The use of hashtags at medical conferences allows material to be discussed and improved on by the experts via online conversation on Twitter. We aim to investigate the utilization of hashtags at the American Association for the Surgery of Trauma (AAST) meetings from 2016 to 2019 and its potential role in knowledge dissemination and meeting participations.MethodsSymplur Signals software was used to analyze hashtags for the AAST meetings by year: #AAST2016, #AAST2017, #AAST2018, #AAST2019.ResultsNumber of tweets decreased significantly from 2016 to 2019 (4500 to 4400 to 3600 to 2600, respectively, p<0.05). Retweets also decreased significantly from 2016 to 2019 (3600 to 3300 to 2600 to 1900, respectively, p<0.05). Users decreased from 2016 to 2019 (1600 to 1400 to 937 to 743, respectively, p<0.05). Despite this decrease, impressions were 5.8 million in 2016, increasing to 8.6 million in 2017, then 9.6 million in 2018 and finally peaking in 2019 where impressions reached 10 million (p<0.05). The top influencer for 2016–2019 was the AAST Twitter account.ConclusionTwitter #AAST 2016–2019 online engagement and interactions have declined during the last 4 years while impressions have grown steadily indicating potential widespread dissemination of trauma-related knowledge and evidence-based practices, and increased online utilization of conference material to trauma surgeons, residents and fellows, trauma scientists, other physicians and the lay public. #AAST online engagement and impressions did not have influence on meeting attendance rates.