#PathTwitter is a well-known virtual community that has historically been positive for pathologists, trainees, and medical students worldwide to communicate, collaborate, and connect for free. However, in 2023, the popular social media platform Twitter (parent company: X Corp.) transitioned to “X” and, with this, #PathTwitter evolved into #PathX. Although the overall user experience of X and Twitter has not changed significantly, this transition brought much anecdotal hesitancy from the online virtual pathology community early on. Thus, the purpose of this review is to discuss the background of Twitter’s importance in pathology, the implications of this transition to the online pathology community, current views from this community regarding Twitter versus X, and to provide an overview of pertinent changes in the platform, as well as of different popular social media platforms that may be used by pathologists in 2024.