CBR can effectively address the issue of unclear elements in safety risk management. However, existing research lacks systematic reviews of its application status and development trends. To systematically summarize the current state of research on the application of CBR in construction safety risk management and to identify future research directions, this paper comprehensively reviewed 45 Chinese and 50 English papers, employing bibliometric analysis and content analysis. The results show that the number of publications shows a fluctuating upward trend and tends to stabilize, spanning multiple disciplines such as environmental science and computer science. Key scholars demonstrate both commonalities and differences in collaboration themes, with China ranking first in publication volume. The research themes have evolved from knowledge construction and methodological exploration toward integration and intelligent convergence. CBR has been widely applied in safety risk identification, analysis and assessment, response, and knowledge management, yet limitations remain regarding control targets, application scenarios, knowledge management, data integration, and workflow optimization. Future research should focus on expanding control targets, developing whole-process management scenarios, establishing collaborative knowledge management mechanisms, integrating multi-source heterogeneous data, and improving workflows to advance the development of intelligent safety risk management in construction projects.