Chinese hamster ovary (CHO) cells remain the dominant platform for therapeutic antibody and biopharmaceutical production, yet productivity bottlenecks persist, particularly for complex molecules. To identify overarching trends in host cell optimization, a systematic review and quantitative cross-study analysis of 164 publications (2011-2024) reporting CHO cell engineering strategies with effects on titer or specific productivity was conducted. Data from 466 engineered targets were extracted and analyzed by strategy, pathway, and production context. The field - driven largely by antibody production - has evolved from simple overexpression toward CRISPR-mediated knockouts, while combinatorial approaches, and engineering of nuclear, epigenetic, and apoptotic/proliferative targets achieved the greatest gains. Despite technological advances, reported improvement folds remained stable, highlighting the need for pathway-informed, multi-target engineering. Future progress in predictive modeling of engineering strategies will depend on standardized models and structured datasets. This review provides a data-driven framework for rational CHO design to support next-generation biotherapeutic production.