The built environment, as a physical spatial entity shaped by human activities, not only constitutes the fundamental framework for residents’ living, working, and recreational activities, but also profoundly impacts public health—particularly respiratory health—through its influence on urban microclimate formation, travel behavior patterns, social interaction structures, and access to natural environments. Utilizing CiteSpace bibliometric analysis tools, this study systematically examines the intellectual progression and research advancements in the field of built environment and respiratory health through a comprehensive review of literature from the Web of Science Core Collection database. By focusing on four core elements of the built environment—”architectural morphology, green space systems, transportation networks, and land use patterns”—the research conducts an in-depth investigation into the operational mechanisms and pathway characteristics through which each dimension affects respiratory health. Simultaneously, it systematically synthesizes methodological frameworks and data source characteristics identified in existing literature, aiming to provide a structured reference system for both theoretical advancement and practical applications in this interdisciplinary domain. The analytical framework employed elucidates the complex interactions between spatial configurations and health outcomes while establishing methodological benchmarks for future investigations.