How revisions are resolved
Insertions are kept as part of the final text. Deletions are removed. Format changes (bold added, font changed) are applied to the result. The Markdown you get is exactly what the document would look like if a reviewer clicked "Accept All Changes" in Word before exporting. No revision metadata leaks into the Markdown.
What happens to comments
By default, comments are stripped — they're not part of the document's content, they're side-notes about it. If you want comments preserved (for context, audit trail, or AI ingestion of the review process), there's an option to emit them as Markdown footnotes anchored to the commented text. The footnote text identifies the comment author and date for traceability.
Why "accept all" isn't always right
If your document has competing tracked changes from multiple reviewers and you haven't reconciled them, "accept all" produces whatever the last edit was — not necessarily what anyone agreed on. For unresolved review docs, finish the editorial process in Word first, then convert. The tool handles the conversion, not the editorial decisions.