Purpose <p>While 85% of residency applicants engage in peri-interview communication, general surgery program directors’ (PDs) perspectives on this practice remain underexplored. This study examines PDs’ perceptions and use of pre- and post-interview communication to illuminate an opaque aspect of the residency selection process.</p> Methods <p>We conducted a mixed-methods study using a cross-sectional, anonymous survey of PDs from ACGME-accredited general surgery programs (August–September 2024). The mixed-methods survey included 20 Likert-type and open-ended questions addressing the influence of peri-interview communication on applicant review and ranking, attitudes toward regulation, and advising practices. Quantitative data were analyzed descriptively, and qualitative responses were thematically coded.</p> Results <p>The survey was sent to 54 PDs and completed by 68.5%. Respondents represented university-based (40.5%), community-based university-affiliated (37.8%), and community-based (21.6%) programs. Nearly half (45.9%) reported pre-interview communication had no effect on interview decisions, though 40.5% noted it could influence decisions based on personalization, geographic ties, or demonstrated interest. Endorsements from mentors, especially known mentors, were viewed favorably by 40.5% of PDs. Post-interview thank-you notes had minimal impact on rank lists (73.0%), but 51.4% found letters of intent somewhat influential. A majority (56.8%) supported at least some limits on peri-interview communication due to concerns about equity, honesty, and message volume. Support for regulation was higher among PDs at larger, university-based programs.</p> Conclusions <p>PDs hold mixed views on peri-interview communication, acknowledging both its strategic value and challenges. Many support policies to regulate communication practices. Future work should address best practices for advising applicants and developing communication guidelines.</p>