Background Historically, women are underrepresented in the field of orthopedic surgery. To evaluate progress in this area, it is important to assess not only representation but also activity at high profile orthopedic conferences in the field. Methods Poster presentations from the 2023 and 2024 AAOS annual meetings were identified via the AAOS ePoster archive. First, second and last authors were recorded for each poster that met inclusion criteria. For each author included in the data, gender was determined and recorded. In addition gender, degree title (as listed on the AAOS website) was recorded, including authors’ AAOS membership status if listed. The Elsevier database, Scopus, was used to determine each authors’ academic influence at the time of data collection. H-indexes, an author specific metric that evaluates scientific output based on publications and citations, were recorded for each author. Results Chi-squared analysis for independence revealed a statistically significant difference in distribution of authorship positions by sex (P=0.03). Using a student's T-test, H-index for male first authors (M = 9, SD = 8) were found to be significantly higher than that for female first authors (M = 5, SD = 6), P < .001. Similar trends were observed for second authors (male: M = 10, SD = 8; female: M = 8, SD = 7), P < .001, and senior authors (male: M = 27, SD = 19; female: M = 17, SD = 18), P < .001. There was also a statistically significant difference in the proportion of male and female authors between the two years (P=0.03). Finally, there was an increase in the proportion of female authors from 14.3% in 2023 to 16.3% in 2024. Conclusion In our analysis of the two most recent AAOS summit authorship data, male authors dominate all authorship positions—first author, second author, and senior author. This disparity is most pronounced in the senior author role, where only 9.6% of senior authors are female. These findings further underscore a persistent gender imbalance in authorship positions at the AAOS annual meeting. Additionally, male authors generally have higher citation impacts than their female counterparts across all author positions. An increase in the proportion of female authors from 14.3% in 2023 to 16.3% in 2024 indicates a positive trend toward greater female representation in orthopedic presentations at the AAOS annual meeting. This significant increase suggests ongoing efforts to promote gender diversity in the field, which remains predominantly male.