Most doctors have submitted papers and very rarely is the paper accepted outright. In fact the majority are not accepted initially. Not to worry, you are in good company. Only 9% of 6000 manuscripts submitted annually to the Journal of the American Medical Association are accepted. Nearly 85% of manuscripts submitted to Plastic and Reconstructive Surgery are initially rejected. Even Stephen Hawkin’s paper on ‘black hole radiation’ was rejected initially. There are a number of articles on ‘how to get published’ and reasons why manuscripts are rejected. This article is different as it also discusses how to approach the reviewer’s comments and advises on approaches to revision of the manuscript. The authors discuss the process of peer review and provide pointers on accepting rejection and tackling the revisions, as well as guidance on peer review. There is a good flow chart that plots choices after manuscript rejections. Candid and well written, this is an easy paper to read and assimilate. It is also useful to learn how to do a good peer review of a manuscript.