OBJECTIVE: Mendelian randomization (MR) utilizes genetic variants as instrumental variables to explore causal associations between exposures and outcomes. Despite a significant increase in MR-related publication volume in recent years, accompanying bibliometric analyses are lacking. Hence, our study aims to conduct a bibliometric analysis of MR articles published within the last 20 years to elucidate the current research landscape and identify potential future directions. METHODS: We searched the Web of Science Core Collection for articles related to MR from 2003 to 2023. The analysis utilized CiteSpace 6.1.R6 and Excel to examine annual publication volume, keywords, journals, countries, institutions, authors, co-cited references, and highly cited articles. RESULTS: A total of 7801 articles in the MR field were retrieved between 2003 and 2023, demonstrating a rapid growth in annual publication volume. "INT J EPIDEMIOL" not only possesses the largest academic output but also boasts the highest co-citation. England contributed the largest number of papers, and the Univ Bristol topped the list with the most articles. George Davey Smith is the most prolific author. The article from Hemani G et al (2018) had the most co-citations. England, the Univ Bristol, and Smith, GD played pivotal roles in highly cited articles. Research hotspots primarily encompassed cardiovascular diseases, metabolic diseases, biomarkers, inflammation, Alzheimer disease, cancer, age. Emerging research frontiers in the last 3 years featured obstructive sleep apnea, psychiatric disorders, major depressive disorder, and coffee consumption. CONCLUSIONS: This study has reviewed the research status and trends in the MR field from 2003 to 2023. These findings provide invaluable insights and guidance for the future development of the MR field.