Medical educators invest significant time and effort into developing and writing educational innovations and research manuscripts. For many, the interval between hitting “submit” and receiving a decision letter can be an anxiety-provoking and uncertain time. In this session, I provide a behind-the-scenes look at what happens to manuscripts at each stage of the review and decision process. Participants will follow the journey of a manuscript through the editorial screening process, reviewer and editor selection, review processing and grading, and decision formulations. I will also discuss the main reasons manuscripts get rejected and will detail three principles for navigating the peer-review process, including how to effectively respond to reviewer comments. Participants will have an opportunity to ask questions and share their own personal strategies for navigating the peer-review process and responding to reviewers/editors.