Background <p>This study aims to conduct a comprehensive bibliometric analysis of research trends and hotspots in hypertrophic scar studies over the past five decades.</p> Method <p>This study conducted a comprehensive literature search on hypertrophic scars using the Web of Science Core Collection. Bibliometric analysis was performed with VOSviewer, CiteSpace, and the R package “bibliometrix,” visualizing collaboration networks, keyword co-occurrence networks, and emerging research trends in the field.</p> Results <p>This study included 3732 publications authored by 14,936 researchers from 7,054 institutions across 657 countries/regions. Ogawa Rei was among the most prolific authors (n = 47). Shanghai Jiao Tong University led with 258 publications. <i>Wound Repair and Regeneration</i> was a high-impact journal in this field. Keyword analysis identified two primary clusters: molecular and cellular mechanisms, and clinical management. Burst analysis of keywords revealed a significant increase in research focus on topics such as “triamcinolone” and “fractional CO₂ laser.”</p> Conclusion <p>This study indicated that molecular mechanisms and therapeutic strategies remained focal points in hypertrophic scar research. Additionally, emerging therapies, such as triamcinolone and fractional CO₂ laser, showed potential to advance treatment approaches. These findings provided critical insights for shaping future research directions.</p> Level of Evidence II <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>