Abstract: 【Abstract】  Background Iodine-refractory thyroid cancer has a poor prognosis and limited conventional treatment options, making it a significant clinical concern. In recent years, research on radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC) has increased, but no researchers have yet conducted a systematic analysis using bibliometric methods. Objective To use bibliometric analysis to summarize research in the field of RAIR-DTC treatment and explore the research hotspots and future development trends from 2004 to 2024. Methods Literature on RAIR-DTC treatment from January 2004 to May 2024 was retrieved from Web of Science (WOS). CiteSpace, VOSviewer, and Microsoft Office Excel were used for visual analysis of publication volume, countries, institutions, authors, keywords, and co-citation networks. Results A total of 677 articles were included. The volume of literature in the RAIR-DTC treatment field has steadily increased. The United States is the most productive and influential country in this field, with The University of Texas MD Anderson Cancer Center having the highest number of publications and citations. Martin Schlumberger and Marcia S. Brose are authoritative authors in this field. Visualization analysis of keywords and citation results revealed that current research hotspots include the clinical efficacy of targeted therapies and disease prognostic factors, while induced redifferentiation and combination therapy may become future research trends. Conclusion Targeted therapies hold significant potential for the treatment of RAIR-DTC. Focusing on prognostic factors provides important guidance for medical practice, while induced redifferentiation and combination therapies offer new directions for future research.