The peer review process is one of less frequently discussed but essential foundations of modern scientific publishing. As stated in The AMA Manual of Style: A Guide for Authors and Editors, written by Cheryl Iverson and other JAMA and Archives Journals staff, “The essence of peer review consists of asking experts: ‘How important and how good is this paper, and how can it be improved?’ This use of expert consultants to advise editors about the selection and improvement of papers has become a standard quality-assessment measure in biomedical publication. It is remarkable that the peer review process depends largely on the efforts of peer reviewers who donate their time—sometimes large amounts of it.”1(p304) Information is expanding rapidly on the Internet and elsewhere. The peer review process provides an excellent, if sometimes imperfect, method to select the best science and assure our readers that knowledgeable reviewers have considered the manuscript thoughtfully. Most of the manuscripts published in the Archives journals have undergone revision based on 1 or more reviewer’s suggestions. They become better manuscripts because the authors are willing to undergo the peer review process. We would hope that even rejected manuscripts benefit by conscientious peer review, which can help the authors improve their manuscripts for future submissions. On behalf of the editorial board and all of our readers, we would like to thank the individuals who participated in this peer review process during 2010.