To characterize Twitter utilization among academic otolaryngologists and evaluate the relationship between Twitter utilization and research productivity. Data were collected manually from accredited US otolaryngology residency programs from July-November 2021. Program and faculty demographics were documented, including citations and H-index for faculty and Doximity reputation and US News and World Report ranking for programs. Twitter metrics were also recorded. Descriptive analyses and multivariable logistic regression models were used to identify predictors of Twitter utilization. Currently, 333 (16%) faculty and 70 (62%) programs have a Twitter account. Of these, 36 (11%) and 27 (39%), respectively, were created in 2020. The regression model indicates that for each 5 unit increase in H-index, the odds of having a Twitter account increase 22% (OR 1.22, 95% CI 1.10-1.34, p = 0.0009). The number of faculty with a Twitter account predicts the existence of program Twitter accounts (OR:1.49, 95% CI 1.01-2.19, p = 0.04). Finally, of the 323 faculty with a Twitter account and available Scopus profile, we found that the number of individuals with Twitter use out of proportion to their academic productivity was low (n = 8/323). The H-index is a significant predictor of faculty Twitter accounts, whereas the number of faculty with Twitter is a significant predictor of program Twitter utilization. Although Twitter utilization is increasing, especially during the coronavirus pandemic, the findings indicate that there is ample room for growth, particularly amongst faculty with strong academic portfolios. NA Laryngoscope, 134:1190-1196, 2024.