Background: A declining trend in the number of pediatric congress abstracts that were ultimately published in the medical literature has been noted recently.Objective: The authors aimed to evaluate whether the conversion rate to manuscripts of congress abstracts submitted to the annual congress of the German Society of Pediatrics and Adolescent Medicine (DGKJ) and its sibling congress the autumn meeting of the German Society of Pediatric Surgery (DGKCH) were also declining and evaluated which factors were linked to a later publication.Material and methods: All abstracts presented at the aforementioned annual congresses in 2018–2020 were evaluated for later publication as a journal manuscript. Factors associated with publication were analyzed via logistic regression using prespecified independent predictors. In addition, the authors analyzed the elapsed time to publication, the journals that published the manuscripts, and by which institutions they were published.Results: Overall conversion rates to journal publication were 40% (116/290) of the annual congress abstracts of the DGKJ and 42% (29/69) for the DGKCH congress. Compared to case reports, clinical abstracts had a much higher chance of being published (adjusted odds ratio 9.3, 95% confidence interval: 5.1–17, p < 0.001) as did experimental abstracts (adjusted odds ratio 23, 95% confidence interval: 4.4–122, p < 0.001). The mode of presentation (podium presentation versus poster) did not influence the chance of later publication (adjusted odds ratio 0.95, 95% confidence interval: 0.5–2.5, p = 0.873). The median time to publication, excluding the 35 that were published before the congress, was 434 days (interquartile range: 219–708 days). In contrast to orally presented abstracts, the affiliated institutions were much more diverse in publications that arose from poster presentations including many nonacademic hospitals. The 145 publications appeared in 96 different journals, only 27 (28%) of which published more than 1 evaluated manuscript and 45 (20%) publications were written in German. Journals affiliated to the DGKJ or DGKCH did not play a relevant role as publication venues with only 5 (3%) published manuscripts.Conclusion: The conversion rates from abstract to manuscript for presentations at German pediatric congresses were higher than expected. Only the abstract’s contents were associated with publication, not the mode of presentation. The relatively large number of manuscripts published in German indicates that there is a need for national journals offering the opportunity to publish in German. This might result in an additional increase of the conversion rate and facilitate publication, particularly by undergraduate and junior researchers.