OBJECTIVE: The modulation of gut microbiota by Traditional Chinese Medicine (TCM) offers a promising approach to cancer treatment. However, a comprehensive bibliometric evaluation of this emerging field is lacking. OBJECTIVE: This study aimed to systematically analyze global research trends, hotspots, and future directions related to TCM regulation of gut microbiota in cancer therapy from 2014 to 2024. METHODS: Publications were retrieved from the Web of Science Core Collection. Bibliometric and visual analyses were conducted using VOSviewer and CiteSpace to examine publication trends, country and institutional collaborations, core authors and journals, keyword co-occurrence, and research frontiers. RESULTS: A total of 340 relevant articles were identified. The number of publications increased significantly after 2018, indicating growing interest in this field. China dominated the research landscape, both in productivity and institutional collaboration. Core research hotspots included "short-chain fatty acids," "tumor microenvironment," "apoptosis," and "immune response." Thematic evolution analysis highlighted a shift from general gut microbiota research to precise molecular mechanisms and targeted regulation. Emerging topics such as "metabolomics" and "immune checkpoint blockade" suggest future directions. CONCLUSION: This study provides a comprehensive overview of the current research landscape on TCM-modulated gut microbiota in cancer treatment. By identifying core contributors, research hotspots, and frontiers, it offers valuable guidance for future investigations and interdisciplinary collaborations in this promising field.