Objectives: This study aims to provide visual knowledge maps highlighting the evolving trends and key focus areas in treating skeletal Class II malocclusion with orthognathic surgery, using a comprehensive bibliometric analysis. Material and Methods: Papers on skeletal Class II malocclusion treated with orthognathic surgery, published between January 2000 and December 2023, were retrospectively sourced from the Web of Science Core Collection. The analysis assessed and visualized the distribution of papers, journals, countries/regions, institutions, authors, and keywords using CiteSpace software. Results: A total of 290 relevant publications were included in the analysis. The annual number of publications showed a steady increase, with a significant rise over the past few years. Concerning output and citations, the leading journal is the American Journal of Orthodontics and Dentofacial Orthopedics. The USA and Centre Hospitalier Universitaire de Lille were the most prolific countries and institutions. Furthermore, orthognathic surgery, malocclusion, and stability were identified as the keywords with the most frequencies. Research interests gradually shifted from orthognathic surgery, malocclusion, and stability to quality of life, orthodontic-orthognathic therapy, and temporomandibular joint. Conclusions: Our results provide knowledge maps of that illustrate advancing research trends and key topics about skeletal Class II malocclusion treated with orthognathic surgery, which are anticipated to provide valuable guidance for future research.