The American Society for Reconstructive Microsurgery (ASRM) annual meeting is a forum to present new research abstracts prior to peer-reviewed publication. The aim of this study is to determine the conversion rate, discrepancies, and time between presentation and publication. A comprehensive literature search was conducted cross-referencing ASRM abstracts presented between 2014 and 2018 with peer-reviewed manuscripts. The title and authors of the abstract and manuscript, the journal of manuscript publication, and time in months between presentation and publication were recorded. The conversion rate was calculated as the proportion of publications to abstracts. Major discrepancies were defined as changes in the purpose, study design, methods, sample size, statistical analysis, results, or conclusions. Minor discrepancies were defined as changes in the title or authorship. Out of 667 oral abstract presentations, 361 (54%) resulted in publication. Of these abstracts, 53 were presented after their corresponding manuscripts were published. The mean conversion rate was 55.52 ± 10.17%. The mean time from presentation to publication was 13.83 months. Minor discrepancies were more frequent than major discrepancies (91 vs. 76%). The most common major and minor discrepancies involved changes in the results (63%) and authorship (79%), respectively. There was a significant association between the year of abstract presentation and whether the conclusion was changed (p = 0.001), but interyear relationships with all other discrepancies failed to reach statistical significance. Only around half of abstracts presented at the annual ASRM conference have reached full publication in peer-reviewed journals, and most are undergoing significant changes between presentation and publication. This may be due to panel discussions at meetings suggesting study modifications, as well as revisions after careful peer review. Altering surgical practices may not be recommended based on abstracts' content.