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Yun-kai Dai,1,* Dan-yan Li,2,* Long-ling Cong,1 Yuan Liao,1 Xue-chuan Wang,1 Jia-wei Fan,1 Wen-jian Chen,1 Chun-hua Fan,1 Teng Ma,3 Yu-jin Wu1 1Department of Gastroenterology, The Affiliated Traditional Chinese Medicine Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 510130, People’s Republic of China; 2Digestive Disease Center, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, People’s Republic of China; 3Department of Acupuncture and Moxibustion Massage, Ningxia People’s Hospital, Yinchuan, Ningxia, 750000, People’s Republic of China*These authors contributed equally to this workYu-jin WuDepartment of Gastroenterology, The Affiliated Traditional Chinese Medicine Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 510130, People’s Republic of China, Email yujin_wu@163.comBackground and Purpose: Chronic atrophic gastritis (CAG), affecting approximately 20– 30% in high-risk populations, contributes to significant morbidity and mortality due to its progression to gastric cancer. Despite two decades of research into its pathogenesis, the vast body of literature has not yet been systematically mapped. A comprehensive bibliometric analysis mapping the field’s evolution, collaborative networks, and knowledge gaps remains lacking. Therefore, we conduct a 20-year bibliometric analysis (2005– 2024) of research on the mechanism of CAG to identify seminal works, emerging themes, evaluate global collaboration networks, and highlight translational challenges and opportunities.Patients and Methods: Data were retrieved from the Web of Science Core Collection (WoSCC) spanning from January 1, 2005, to December 31, 2024. Bibliometric analysis was performed using CiteSpace and VOSviewer to analyze publication trends, influential authors and institutions, keyword clusters, and citation bursts.Results: A total of 954 papers were identified, with China leading in publication output (41.51%), followed by the USA (15.20%). The USA demonstrated high centrality in international collaboration. Key journals included WORLD J GASTROENTERO and GASTROENTEROLOGY. Prolific authors such as Liu Yuetao and co-cited authors like CORREA P were identified. Keyword analysis revealed “Helicobacter pylori” as the most prominent term, with clusters focusing on traditional Chinese medicine, macrophage biology, and gastric intestinal metaplasia.Conclusion: The study highlights the significant research output and collaboration in CAG, emphasizing the importance of interdisciplinary approaches and international partnerships. Future research should focus on integrating traditional knowledge with modern mechanistic studies and addressing emerging themes such as microbiome dysbiosis and precision medicine.Keywords: chronic atrophic gastritis, bibliometrics, Helicobacter pylori, mechanistic studies