Aim This study analyzed the health policy research domain in Iran from 1987 to 2025, examining publication trends within the Web of Science (WoS) database and identifying core sub-domains and conceptual trajectories.

Instrument & Methods Using co-word and network analysis techniques, 4,229 WoS-indexed documents were evaluated. Cluster analysis and strategic diagrams were applied to map the field's conceptual structure, delineate thematic sub-domains, and examine their interrelationships.

Findings The findings revealed nine distinct clusters: 1. Health System Governance, Policymaking, and Management; 2. Qualitative Research in Nursing and Hospital Care Services; 3. Mental Health, Quality of Life, and Vulnerable Populations; 4. Epidemiology of Noncommunicable Diseases and Health Inequities; 5. Public Health, Environmental Health, and Smart Technologies; 6. Epidemiology, Mortality, and Global Burden of Disease; 7. COVID-19 Pandemic and Infectious Diseases; 8. Reproductive Health, Digital Health, and Social Challenges; and 9. Knowledge, Attitude, and Practice regarding Health Behaviors.

Conclusion The four-decade trajectory of Iranian health policy research demonstrates structural transformation and scientific maturity, with publication output surging dramatically post-2020. Conceptually, the discipline is anchored in health system governance and disease burden assessment, further accelerated by emerging health crises, particularly COVID-19. This process evolved health policy into an interdisciplinary, decision-oriented, and evidence-based discipline. Furthermore, emerging domains such as smart technologies (including Artificial Intelligence and GIS), digital health, environmental determinants, and mental health are poised to shape future research horizons. Ultimately, mapping this knowledge structure provides a guiding roadmap for decision-makers, academic institutions, and research policymakers to prioritize strategic agendas and optimize resource allocation.