• Scientific questions: Maximum biosafety level pathogens (MBLPs) pose a severe and persistent threat to global public health. Research involving live agents on MBLPs must be conducted within corresponding maximum biosafety level laboratories (MBSL-Ls). However, the global research landscape remains unclear due to the lack of a unified, global list of MBSL-Ls, hindering a comprehensive analysis of the field’s output, trends, and key contributors. • Evidence before this study: This study presents the first bibliometric analysis to systematically delineate the overall landscape of global live-agent MBLP research. It maps the field’s developmental trajectory, collaborative networks, and research hotspots, providing an evidence-based foundation for understanding its evolution and informing future strategic priorities. • New findings: Live-agent research on MBLPs has transitioned to a sustained high-output plateau since 2015, with the research frontier shifting towards applied medical countermeasures, particularly vaccine evaluation. While the United States-led collaboration network dominates, significant imbalances persist in global research partnerships. Laboratories handling maximum biosafety level pathogens are pivotal to advancing basic research and technological innovation for preventing and treating associated infectious diseases. Herein, we conduct a bibliometric analysis to identify global research trends and hotspots in this field, with the aim of guiding future scientific strategy and fostering international collaboration. A total of 604 relevant English publications (1980–2025) from the Web of Science Core Collection were analyzed using CiteSpace, VOSviewer, and the bibliometrix R package. The results delineate a two-phase growth pattern: annual publication output transitioned from a prolonged period of slow growth to a sustained high-output plateau following the 2014–2016 Ebola epidemic. Ebola virus is the most frequently studied pathogen, while the Journal of Infectious Diseases is the most prolific journal. Keyword analysis revealed an evolution in research focus from basic research towards applied medical countermeasures, with current priorities centered on evaluating the safety and efficacy of vaccines. The United States emerged as the dominant force, producing the leading institutions, core researchers, and maintained a robust collaborative network with partners like Canada and Germany that significantly outpaced Asian countries. This concentration of research effort, observed within our pathogen cohort, underscores the need for more balanced global cooperation focused on a wider spectrum of maximum biosafety level pathogens.
Huang et al. (Fri,) studied this question.