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We review and define the current state of the art as relating to discrete event simulation in healthcare-related systems. A review of published literature over the past five years (2017–2021) was conducted, building upon previously published work. PubMed and EBSCOhost were searched for journal articles on discrete event simulation in healthcare resulting in identification of 933 unique articles. Of these about half were excluded at the title/abstract level and 154 at the full text level, leaving 311 papers to analyze. These were categorized, then analyzed by category and collectively to identify publication volume over time, disease focus, activity levels by country, software systems used, and sizes of healthcare unit under study. A total of 1196 articles were initially identified. This list was narrowed down to 311 for systematic review. Following the schema from prior systematic reviews, the articles fell into four broad categories: health care systems operations (HCSO), disease progression modeling (DPM), screening modeling (SM), and health behavior modeling (HBM). We found that discrete event simulation in healthcare has continued to increase year-over-year, as well as expand into diverse areas of the healthcare system. In addition, this study adds extra bibliometric dimensions to gain more insight into the details and nuances of how and where simulation is being used in healthcare.