Background <p>Epilepsy is a chronic neurological disorder affecting millions globally, with a significant portion of patients remaining pharmacoresistant. Acupuncture, particularly transcutaneous auricular vagus nerve stimulation (taVNS), has gained attention for its potential in epilepsy management. This study conducts a comprehensive bibliometric analysis of global research trends in acupuncture for epilepsy from 2000 to 2024 to assess publication trends, key research themes, influential articles, and research hotspots.</p> Methods <p>A systematic search was conducted using the Web of Science Core Collection (WoSCC) database for articles published between 2000 and 2025. Bibliometrix and VOSviewer were used for bibliometric and thematic analysis, mapping research trends, co-occurrence networks, and thematic evolution.</p> Results <p>A steady increase in publications was observed, with notable contributions from China and institutions like Fudan University. Key research themes include vagus nerve stimulation (VNS), electroacupuncture, and neuroinflammation, highlighting the shift toward neuromodulation. Citation impact was highest in journals such as <i>Evidence-Based Complementary and Alternative Medicine</i>. Emerging trends point to taVNS and neuroprotection as significant research areas, with clinical studies increasingly focusing on the biological mechanisms behind acupuncture’s anticonvulsant effects.</p> Conclusions <p>Acupuncture for epilepsy has grown in global recognition, especially in VNS and electroacupuncture. However, further high-quality clinical trials and standardized protocols are required to establish acupuncture’s efficacy in clinical epilepsy treatment, particularly in pharmacoresistant cases.</p>