INTRODUCTION: Bibliometric analysis quantitatively measures the impact of scientific articles within their respective fields, with citation counts being a key indicator of influence. This study aimed to identify the top 100 most-cited articles related to apical periodontitis and systemic health, analyzing their main characteristics. METHODS: The top 100 most-cited articles were identified using Web of Science. Data on publication year, citations, title, authors, institutions, countries, journal impact factor, study design, keywords, and open access status were extracted. VOSviewer software analyzed author and keyword networks, while Power BI evaluated international collaborations, study design, and citations. Poisson regression was performed in R software (P < .05). RESULTS: We reviewed 1,141 studies and selected the top 100 most-cited articles, totaling 4,744 citations (4,005 excluding self-citations), with an average of 47.44 citations per article. The most-cited article, a 2015 review by Segura-Egea JJ, had 187 citations. The highest publication activity was in 2017 and 2019 (n = 13). Leading institutions were the University of Sevilla and São Paulo State University. Europe accounted for 41% of publications and 2,251 citations, followed by Latin America and the United States. Cross-sectional studies were the most common (18%), with systemic diseases, particularly coronary heart disease and diabetes mellitus, as dominant topics. Most articles (69%) were published in journals with an impact factor above 3, with the Journal of Endodontics leading in number of articles. CONCLUSIONS: This bibliometric review highlights the increasing research interest in the relationship between apical periodontitis and systemic health, with most contributions coming from Europe and Latin America.