BACKGROUND: Actinic keratosis (AK) is a precancerous intraepidermal lesion characterized by atypical keratinocyte proliferation. In recent years, research on AK has made continuous progress, but there has been no bibliometric study on it. This study aims to use bibliometric methods to analyze the research and treatment hotspots of AK in recent years, in order to further understand the development direction and frontiers of this field. METHODS: Core literature related to AK was retrieved from the Web of Science Core Collection (WoSCC) database. CiteSpace and VOSviewer software were employed to conduct a detailed analysis based on publication output, countries/regions, research institutions, journals, authors, and keywords. RESULTS: A total of 2,796 documents were included in this study. The United States, Germany, and Italy emerged as the leading contributors to AK research, with the University of Copenhagen identified as the most prolific research institution. Among authors, Pellacani G has published the highest number of articles, while the Journal of the European Academy of Dermatology and Venereology ranks as the most influential journal in this field. The main research hotspots and frontiers in the field of AK are as follows: (1) Molecular mechanisms of malignant transformation to cutaneous squamous cell carcinoma (cSCC), particularly involving genomic instability (eg, TP53 mutations); (2) Personalized therapies optimized through immune profiling, genetic biomarkers, and lesion morphology; (3) Emerging frontiers include non-invasive diagnostic technologies and treatment monitoring, which are receiving significant attention. CONCLUSION: This study summarizes the current research status and key areas of focus in AK, providing a foundation for clinical decision-making and guiding future research directions.