Annual meetings of the Medical Library Association have been a part of the culture of medical librarians in North America since 1898. With only four exceptions (one during WWI and three during WWII) medical librarians have met annually for nearly 100 years to conduct their business, share ideas, present papers, attend continuing education courses, view exhibits, and have fun. Based on the writer's research and personal experience, his reflections contain a summary of the history and development of these meetings since the first one in Philadelphia in 1898, an assessment of their content and value, and recommendations.