Objective:  Clinical literature reviews, especially systematic reviews, require the management and evaluation of large amounts of bibliographic data.  Although the methodology for performing reviews is well documented, few sources share practical guidance on how to electronically manage citation data in order to efficiently inventory, organize, and assess published material.  Spreadsheet tools (e.g., Excel®) give researchers unparalleled freedom to manipulate a large volume of information culled from source databases (e.g., MEDLINE®); however, many researchers lack a blueprint for structuring their data to facilitate review.  Methods:  We describe a process of erecting “data scaffolding” that is critical to transforming a literature review spreadsheet into an agile, manipulable source of information that can triage, sort, and report on materials retrieved for review. Results:  Using a sample of literature data pulled from PubMed®, we describe several ideas for adding key structural components to a spreadsheet of citations that bring flexibility and functionality to the processes of article review and analysis.  In doing so, we also describe the hows and whys of spreadsheet design to facilitate literature review, such as the importance of the spreadsheet layout; the addition of flag fields to use medical subject headings or key words to easily sort, organize, identify/retrieve, navigate, and summarize citations; and ways of leveraging built-in spreadsheet features such as autofilters, freeze-panes, and subtotals that can greatly facilitate the inventory and management of large volumes of citation data to support literature reviews. Conclusions:  In an era of increasing volumes of published literature and the proliferation of rigorous, formalized, systematic and non-systematic reviews, researchers must adapt to growing demands.  Existing spreadsheet tools can be leveraged to effectively meet these demands, in ways that not only provide for greater efficiency but in ways that may result in enhanced research capabilities.