Purpose <p>Citation-based metrics are traditionally used to assess research impact, but they have limitations. In today’s digital age, newer social-media–based metrics, such as Altmetric scores, may be important. An Altmetric score is generated on the basis of the amount of engagement a research article has on online media platforms such as X (formerly Twitter). This study’s objectives were to understand the relationship between the Altmetric score and article citation count/traditional metrics in the anesthesiology literature as well as to determine predictors of higher Altmetric scores.</p> Methods <p>In this cross-sectional observational study, we identified two sets of articles (the 100 top-cited articles and 100 articles selected at random) published in 2019 and 2020 for each of the top 5 general anesthesiology journals ranked by 2021 impact factor: Anaesthesia, the British Journal of Anaesthesia, the Journal of Clinical Anesthesia, Anesthesiology, and the Canadian Journal of Anesthesia. Two independent researchers extracted data, including the citation count and Altmetric total and component scores. Following this, we performed correlation analyses between various parameters.</p> Results <p>The journal <i>Anaesthesia</i> had the highest impact factor and positive correlation between Altmetric score and article citation count (ρ = 0.46; P &lt; 0.001). There was a moderate positive correlation between the citation count and the Altmetric score for all journals in the randomly selected group, with the exception of the Journal of Clinical Anesthesia. Greater X engagement was a good predictor relative to the other factors for a higher Altmetric score.</p> Conclusions <p>For most anesthesiology journals studied, the Altmetric score showed a positive correlation with the citation count and impact factor. Altmetrics have the potential to show the social impact of research in anesthesia, but this is limited to X engagement. The Altmetric score is largely influenced by greater social media engagement on X.</p>