Background: Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by persistent joint inflammation. Recent studies suggest that gut microbiota imbalances may influence the onset and progression of RA. This study aims to evaluate the current research on gut microbiota in RA, identify emerging trends, and offer insights for the precision treatment of RA. Methods: The authors analyzed articles on gut microbiota and RA published from 2004 to 2023, using the Web of Science Core Collection database. Bibliometric methods employed tools such as VOSviewer, CiteSpace, and Bibliometrix to conduct visual analyses of authors, institutions, countries, references, and keywords. A total of 1,085 articles were included in the analysis. Results: A notable increase in annual publications reflects growing interest in this field. The analysis revealed significant contributions from the USA (320 articles), China (312), Italy (89), the UK (80), Germany (64), and Japan (54), primarily in English. Simultaneously, the contributions and collaborations among institutions and authors in this field are discussed. Furthermore, the analysis of co-cited references and keywords elucidated contemporary hotspots in the field. A significant focus centered on the role of gut microbiota in the pathogenesis of RA. Another prominent hotspot involved the restoration of microbial balance through dietary modifications and the administration of probiotics, thereby preventing and treating RA. Conclusion: This study summarized advancements in gut microbiota and RA research from 2004 to 2023, predicting future trends. Key areas of focus will likely include understanding molecular mechanisms and exploring dietary interventions and probiotics to improve RA treatment outcomes.