This bibliometric analysis examines acupuncture research in the treatment of primary osteoporosis based on 775 publications from the Web of Science Core Collection database from 2000 to 2025. Countries, institutions, authors, keywords, and literature were analyzed using software such as CiteSpace, gCLUTO, SPSS 27.0, and Microsoft Charticulator. The most cited journal is "Osteoporosis International" and the United States has the largest research output. The most prolific institution is Guangzhou University of Chinese Medicine, the authors with the most relevant literature are Cortet Bernard and Kanis JA. The most common keyword is women after menopause. New research foci include postmenopausal women, complications of osteoporosis, traditional Chinese medicine, and osteoporosis prevention. The study provides an overview of trends over the past two decades and recommends focusing on these areas.