Background: Systemic immune inflammatory indices derived from complete blood count parameters have gained increasing attention in emergency medicine as rapid, accessible biomarkers for risk stratification and prognostic assessment. Although their clinical utility has been widely investigated, the global research landscape, thematic evolution and structural characteristics of this literature have not yet been comprehensively evaluated. Methods: A bibliometric analysis was conducted using data retrieved from the Web of Science Core Collection. Original research articles published in English between 2020 and 2025 that investigated systemic immune inflammatory indices in emergency department settings were included. Performance analysis was performed to assess publication trends, citation patterns, and the productivity of countries, institutions and journals. Science mapping techniques, including keyword co occurrence and collaboration network analyses, were applied to explore thematic structures and research hotspots. Results: A total of 359 original articles were included. Annual publication output increased markedly between 2020 and 2022, followed by a sustained volume of publications through 2025. The mean number of citations per article was 7.35 (median 3; IQR 9), and the mean citation density was 1.88 (median 1.00; IQR 2.25). Türkiye was the leading contributing country with 154 publications (42.9%), followed by China (41; 11.4%) and the United States (28; 7.8%). The American Journal of Emergency Medicine demonstrated the highest overall citation impact, while multidisciplinary journals showed higher mean citation rates. Keyword analyses identified emergency department, mortality, COVID-19 and prognosis as central themes, with a temporal shift toward outcome focused and decision support oriented research. Conclusion: Research on systemic immune inflammatory indices in emergency medicine has expanded rapidly in recent years and evolved toward clinically relevant outcomes and prognostic applications.