Objective: To perform a bibliometric analysis in the field of thyroid-associated ophthalmopathy (TAO) nonsurgical treatment research over the past 40 years to characterize its current global trends and emerging hotspots, with special focus on the novel biological therapies targeting immunological and inflammatory pathways, as well as the pathology behind. Methods: This bibliometric analysis examined 1600 publications collected from the Web of Science Core Collection (WoSCC) database on TAO research from 1983 to 2023. Important subtopics identified by bibliometric characterization were further discussed surrounding biological therapies and immunology-related pathology. Results: From 1983 to 2023, the annual global publications increased rapidly and an even higher research interest in the future was indicated by curve fitting. Thyroid published the most manuscripts, and the United States, the University of Pisa and Marcocci Claudio were the most productive and impactful country, institution and author respectively. The co-occurrence cluster analysis of the top 80 keywords formed three clusters: (1) possible mechanism and cellular biology of TAO (also the possible nonsurgical treatment target). (2) treatments of TAO. (3) thyroid disorders and other factors. These co-occurrence clusters indicated research hotspots and their evolutionary patterns. Rituximab and teprotumumab as well as their related publications were keywords and references with strong citation bursts lasting till now, indicating immunity-related targeted biologicals as the emerging frontiers of TAO nonsurgical treatments. Conclusions: Over the last four decades, there has been a progressive increase in the number of publications and citations on research related to TAO nonsurgical treatment. Our study provided a thorough overview of the evolutionary landscape for nonsurgical treatment of TAO, showing new insight into the development of TAO immunological pathogenesis research, and the rise of biological therapies. It shed light on its global collaboration patterns, current trends, research hotspots, and emerging frontiers, hopefully could facilitate collaborative initiatives and guiding future research.