Background <p>High-flow nasal oxygen (HFNO) has become an essential respiratory support modality in anesthesia, intensive care, and emergency medicine. This bibliometric analysis systematically evaluates the research landscape and technological developments in HFNO monitoring and management.</p> Methods <p>Relevant publications were retrieved from the Web of Science Core Collection database using a comprehensive search strategy. Bibliometric analysis and visualization of countries, institutions, authors, journals, and keywords were performed using CiteSpace, VOSviewer, and Scimago Graphica. The analysis covered publications from 2004 to 2023.</p> Results <p>A total of 2782 publications on HFNO were identified. The United States was the leading country in terms of research output, while the University of Toronto was the most productive institution. Jie Li was the most prolific author, and Respiratory Care was the journal with the highest number of publications. The most common keywords included “COVID-19”, “noninvasive ventilation”, “high-flow nasal cannula”, “therapy”, and “ventilation”. Keyword emergence testing revealed that Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) is a recent research hotspot.</p> Conclusion <p>The study reveals a significant increase in HFNO research publications worldwide, a trend that is expected to continue. Future research should focus on exploring HFNO applications in diverse clinical settings, optimizing personalized treatment strategies, and integrating other respiratory support techniques to enhance its efficacy and safety.</p>