Background: Understanding the differences between articles that amass a high number of citations and those that receive very few allows investigators to write journal articles that maximize the impact of their research. There are minimal data regarding these two cohorts in the cardiothoracic surgery literature. Methods: We identified all primary research articles from 1998 to 2008 from The Journal of Thoracic and Cardiovascular Surgery, The Journal of Cardiac Surgery, The Annals of Thoracic Surgery, and The European Journal of Cardio-Thoracic Surgery (n = 4276). Eighty-seven of these articles accrued 0 or only 1 citation within 10 y of publication. We compared this “low citation” cohort to the “high citation” cohort made up of the 87 highest-cited articles from the same journals over the same time period. Results: When compared with the low-citation articles, high-citation articles were significantly more likely to be clinical in nature (P < 0.0001), have observational study design (P < 0.0001), involve multidisciplinary authorship (P < 0.0001), and have more funding reported (P = 0.0039). With regard to technical aspects of the article, the high-citation articles were likely to have longer titles (P = 0.0086), punctuation in the title (P = 0.0027), longer abstracts (P = 0.0007), more words in the manuscript (P < 0.0001), more authors (P < 0.0001), more declared conflict of interests (P = 0.0167), more references (P < 0.0001), more tables (P < 0.0001), more figures (P = 0.0024), and more pages (P < 0.0001). There was no significant difference in the year of publication among both cohorts. Conclusions: This review suggests that there are several important distinguishing characteristics that should be considered by investigators when designing and implementing cardiothoracic research studies to maximize the impact of their published research.