Purpose <p>Adolescent idiopathic scoliosis (AIS) is the most common spinal deformity affecting adolescents, yet comprehensive analysis of global research trends remains limited. This study aims to identify research hotspots, collaboration patterns, and emerging frontiers to guide future research priorities.</p> Methods <p>Publications on AIS from 1990 to October 2025 were retrieved from the Web of Science Core Collection. Bibliometric analysis was conducted on 3,816 publications using CiteSpace, VOSviewer, Bibliometrix, and an online platform (<a href="http://bibliometric.com">http://bibliometric.com</a>).</p> Results <p>A total of 3,816 publications were analyzed, indicating a significant acceleration in annual output post-2015. The United States (27.78%) and China (25.86%) contributed over half of the global output, suggesting a bipolar pattern of research output. While the U.S. leads in total citations, China suggests the most rapid recent growth. Network analysis identified <i>Spine</i>, <i>European Spine Journal</i>, and <i>Spine Deformity</i> as the primary dissemination venues and revealed robust domestic research clusters contrasted by sparse cross-continental collaboration. Research hotspots may have evolved from foundational classification systems and instrumentation to evidence-based conservative management. Recent frontiers (2022–2025) indicate a paradigm shift toward precision medicine, characterized by the emergence of “vertebral body tethering” (VBT) and “artificial intelligence” (AI).</p> Conclusion <p>Global AIS research appears to have evolved from descriptive classification and static surgical correction to a multidisciplinary science focused on physiological preservation and predictive modeling. Despite strong regional hubs, establishing global standards requires enhanced international integration. Future priorities lie in validating emerging non-fusion techniques and AI applications through large-scale, cross-cultural collaborative studies.</p>