Background As more surgeons use Twitter, it is vital to understand how to engage users. Surgeons need timely education on multidrug-resistant organisms to prescribe effective antibiotics. We evaluated Twitter as a tool to engage and educate surgeons in emerging infectious disease (ID) topics on antibiotic resistance and antimicrobial stewardship. Methods This was a 3-month prospective cohort study with surgeons who volunteered after attending Twitter Grand Rounds presentation and workshop. Pharmacists tweeted ID topics relevant to surgeons, and each tweet's reach, impressions, and engagement were calculated. Results A total of 5117 tweets were sent: 4089 by 21 surgeons and 1028 by study pharmacists. Pharmacists sent 451 ID tweets, and surgeons engaged in 72 ID tweets: 31 retweeted, 29 replied, and 12 “liked” for a potential reach of 5101, potential impressions of 38 784, and actual impressions of 15,895. The top ID tweet topics by actual impressions were antibiotic resistance (3005), global antibiotic stewardship (2257), “superbugs” (2121), and Clostridium difficile (1181). Of the 31 ID retweets by surgeons, 81% had links to articles versus 19% without links (P = 0.54). Grand Rounds evaluations identified that 81% rated the presentation topic as excellent and 77% felt Twitter was relevant to their practice. The conference hashtag #TwitterGrandRounds engaged surgeons tweeting from other institutions and generated an additional 217,317 potential impressions. Conclusions Twitter engaged surgeons in ID and antimicrobial stewardship topics and provided real-time education around antimicrobial resistance. Future studies should evaluate whether engagement and education via tweets impact actual antimicrobial use and the rates of antimicrobial resistance.