In the field of mathematics education, the importance of visualization cannot be overstated, especially in mathematical problem-solving. The review's objective is to investigate visualization in mathematical problem-solving in secondary schools. Its status, regional contribution, subject domains, and outcomes should be the focus and characteristics of visualization and research methods. The PRISMA method was used to conduct this review study, which resulted in the identification of 19 empirical studies from 1,135 studies based on the Web of Science and Scopus in 2006-2024. As a result, 2024 revealed trends in empirical studies on visualization in secondary school mathematics problem-solving. The country with the highest number of studies was the USA The most frequently used visualization was drawing and GeoGebra. Individual differences in the studies included grade, age, cognitive style, disabilities, and gifted students. While effective research mainly focused on attitudes, self-efficacy, and satisfaction. Problem-solving strategies, the VIMATE framework, Van Hiele, modelling performance, and visualization methods were the commonly adopted pedagogical approaches. Geometry and word problem-solving are the most common content used for visualization. Using quantitative research methods and knowledge tests for data collection. The findings have substantial ramifications for the design and implementation processes. of visualization in secondary school mathematical problem-solving for 21st century skills.