This study determined if the process of editorial peer review is the same for all medical journals. Two categories of indexed US medical journals were examined: group 1 consisted mainly of well-known, clinically oriented journals, while group 2 was composed primarily of interdisciplinary or specialized journals. Data were collected through a series of interviews and questionnaires. All 16 group 1 editors or managing editors were interviewed. Questionnaires were mailed to 124 group 2 editors (69.4% were returned). Results showed that, although some of the practices of editorial peer review are the same, the two groups of journals had distinct editorial peer review practices. Group 1 made less use of editorial peer review than group 2 by relying on the editorial staff at several important decision points.