The "Belt and Road" Initiative (BRI), i.e., the official Chinese term for the "Silk Road Economic Belt" and the "21st Century Maritime Silk Road", was proposed to share China's development opportunities with BRI-related countries and achieve common prosperity. Though the BRI itself conveys rich social and economic connotations, ecosystem health and the environmental problems in the Belt and Road regions are scientific issues. In this study, papers relating to the ecological issues of the BRI between January 2013 and December 2021 were collected and analyzed via CiteSpace. We found that some ecological issues were involved with the environmental challenges posed by the BRI, whereas others were, to a certain extent, subjective assumptions. Accordingly, we identified and classified the limitations and constraints of those environmental views about the BRI. By emphasizing that scientific data is key to explaining the ecological problems, we advanced four prospects for ecosystem health and environmental geography studies in the Belt and Road regions: (1) Spatial analysis and monitoring technology for the environment; (2) Clarification of the characteristics and mechanisms of the ecosystem and environments; (3) A focus on the interaction between the economy and the environment; (4) Specific and targeted strategies and solutions to different environmental problems.