Internal swelling reactions (ISRs) are among the most critical deterioration mechanisms affecting infrastructure’s durability worldwide. While preventative measures for new structures have been extensively explored, effective protocols for diagnosing and prognosing ISR-affected structures, especially at their early stages, are still required. Therefore, through a comprehensive bibliometric analysis, this study focuses on exploring the evolution and current methods for assessing and forecasting ISR damage in concrete structures. For diagnosis, a shift from concrete petrography and non-destructive techniques (NDTs) towards more comprehensive methods (i.e., multi-level assessment) with the stiffness damage test (SDT) and damage rating index (DRI) is observed. Moreover, it identifies the valuable inputs from residual expansion and pore solution analysis as relevant parameters for prognosis. Based on these findings, a structured management framework is proposed aiming to refine the diagnosis and prognosis processes of ISR-affected infrastructure, ultimately contributing to improved long-term structural health and maintenance strategies.