BACKGROUND: Whether research engagement on social media and other public platforms results in increased citations in obstetrics and gynecology remains uncertain. The Altmetric Attention Score is a metric of research influence based on mentions on social media and public platforms, such as newsfeeds and Wikipedia. The correlation between Altmetric Attention Scores, absolute citation rates, and the Relative Citation Ratio (a novel metric of research engagement also based on citation rates) in obstetrics and gynecology research is uncertain. OBJECTIVE: To evaluate the correlation between Altmetric Attention Score, absolute citation rate, and Relative Citation Ratio for articles published in obstetrics and gynecology journals from 2004 to 2019. Our second objective was to identify, characterize, and compare the 100 articles with highest Altmetric Attention Scores, the 100 most-cited articles, and the 100 articles with highest Relative Citation Ratios. STUDY DESIGN: We performed a cross-sectional altmetric and bibliometric study of all obstetrics and gynecology articles indexed in the National Institutes of Health Open Citation Collection from 2004 to 2019. Articles were included if they were published in obstetrics and gynecology journals according to InCites Journal Citation Reports indexing. Citation data, including citation numbers and Relative Citation Ratios, were downloaded on March 20, 2021 and merged with altmetric data from the Altmetric Explorer on the basis of each article's unique PubMed identification number. We assessed correlation between Altmetric Attention Scores and number of citations and Altmetric Attention Scores and Relative Citation Ratios by calculating the Pearson correlation coefficient. The 100 articles with highest Altmetric Attention Scores, the 100 most-cited articles, and the 100 articles with highest Relative Citation Ratios were characterized and compared using means (standard deviations) and mean differences (95% confidence intervals). RESULTS: There were 156,592 articles published in 82 obstetrics and gynecology journals and indexed in the National Institutes of Health Open Citation Collection between 2004 and 2019. The correlation coefficient was 0.18 (95% confidence interval, 0.17-0.19) for Altmetric Attention Scores vs number of citations and 0.10 (95% confidence interval, 0.09-0.11) for Altmetric Attention Scores vs Relative Citation Ratios. There was no overlap among the 100 articles on the highest Altmetric Attention Score list and the 100 most-cited list, and there was minimal overlap among the 100 articles on the highest Altmetric Attention Score list and the 100 highest Relative Citation Ratio list (98 unique articles on each list). Articles with highest Altmetric Attention Scores generated substantially more engagement on social media and other public platforms than most-cited articles (mean Altmetric Attention Score, 763.1 [standard deviation, 520.8] vs 49.9 [standard deviation, 81.6]; mean difference, -713.2 [95% confidence interval, -819.9 to -606.6]) and highest Relative Citation Ratio articles (mean, 116.2 [standard deviation, 415.9]; mean difference, -661.5 [95% confidence interval, -746.2 to -576.9]). In contrast, the articles with highest Altmetric Attention Scores generated far fewer citations than most-cited articles (mean, 39.7 [standard deviation, 47.6] vs 541.8 [standard deviation, 312.8]; mean difference, 502.0 [95% confidence interval, 439.0-565.0]) and highest Relative Citation Ratio articles (mean, 458.9 [standard deviation, 363.5]; mean difference, 427.7 [95% confidence interval, 353.8-501.6]). Nearly half of articles with highest Altmetric Attention Scores were basic/translational studies, often about menopause and environmental factors impacting fertility, whereas most-cited articles and articles with highest Relative Citation Ratios were more likely to be reviews and consensus statements, respectively, often about placentation and polycystic ovary syndrome, respectively. Articles with highest Altmetric Attention Scores were more likely to be published as open-access. CONCLUSION: There seems to be weak short-term correlation between Altmetric Attention Scores and citation rates. Further study is warranted to ascertain whether there may be long-term correlation between alternative metrics and citation rates in obstetrics and gynecology.