Objective To analyze the research hotspots and emerging trends in environmental health in China, 2019—2024.

Methods Using China National Knowledge Infrastructure (CNKI) and Web of Science as data sources, we retrieved environmental health-related literature indexed between January 1, 2019 and December 31, 2024. CiteSpace 6.4.R1 was employed to perform burst detection and co-occurrence network analysis of authors, institutions, and keywords. Key indicators including Q-value, S-value, betweenness centrality, and burst intensity were used to evaluate research hotspots and evolutionary pathways.

Results A total of 1187 articles from CNKI and 5085 articles from Web of Science were included. From 2019 to 2024, the number of publications on environmental health in China exhibited fluctuations during different periods. CNKI articles surged by 51.89% between 2023 and 2024, while Web of Science publications surged in 2022 and then declined in 2023—2024, with the smallest gap between Chinese and English publications observed in 2024. The collaborative network exhibited a hub-and-spoke structure, showing sparse inter-institutional cooperation (network density: 0.007 5 for Chinese vs. 0.019 8 for English). Core nodes were disease prevention and control systems and top-tier universities, with international collaborations primarily focusing on Belt and Road Initiative countries. The co-occurrence analysis of keywords revealed a paradigm shift from concentration-effect models to exposure-metabolism-gene mechanisms. Three emerging themes were identified: new contaminants (trichloromethane, carbon tetrachloride, and PFAS), antibiotic resistance genes, and health effects of climate change. Artificial intelligence method ology was the only method ological term showing sustained bursts from 2022 to 2024.

Conclusion Policy-driven initiatives, institutional collaboration, and interdisciplinary integration have jointly propelled the substantial progress in China's environmental health research. Future studies should focus on building a big data platform, strengthening cohort studies and intervention validation, and promoting international cooperation.