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Artificial intelligence (AI) has been increasingly integrated into medical publishing, hopefully improving efficiency and accuracy, but serious concerns persist regarding ethical implications, authorship attribution, and content reliability. We aimed at understanding the perspectives of editors of medical journals on AI. A structured online questionnaire was developed and distributed to Editors-in-Chief of medical journals worldwide. The survey comprised 27 concise questions exploring demographics, journal practices, and perspectives on AI in editorial workflows. Quantitative data were analyzed using descriptive statistics to summarize usage patterns, perceived benefits, risks, and future expectations. A total of 59 Editors-in-Chief completed the survey (response rate: 19%), with replies suggesting substantial variability in beliefs and attitudes towards AI for publication in medical journals. Artificial intelligence tools were already in use by 49% of journals, mainly for plagiarism detection (76%) and data verification (35%). Only 9% of responders reported that journals used AI for both scientific and linguistic review. Time savings (79%) and cost reduction (43%) were the most commonly cited benefits, and concerns included potential bias (71%) and lack of accountability (60%). Overall, 81% of responders anticipated a major role for AI in publishing within 10 years. Exploratory analyses suggested several potential associations between replies and respondent or journal features, requiring further validation in future surveys. In conclusion, the present survey on attitudes toward AI in publication in medical journals suggests that Editors-in-Chief are cautiously adopting AI in their editorial workflow, supporting its operational use while explicitly calling for clear guidance to address ethical and regulatory concerns.