This numerical study examines the thermal-hydraulic performance of helical coil heat exchangers (HCHEs) using twisted tubes versus conventional circular tubes. The effects of Reynolds number (Re = 10,000 to 100,000), pitch length (11, 7.2, 5.5, 3.6 mm), and twisted tube orientation (co-current, counter-current) on heat transfer efficiency and pressure drop were investigated. The results show that higher Reynolds numbers can reduce the Resistance factor by approximately 25 % and improve heat transfer by approximately 35 %. An optimal pitch length of 5.5 mm was found to balance enhanced heat transfer and manageable pumping costs. Twisted tubes demonstrate significant performance advantages at lower Re, with 20–33 % higher Performance Evaluation Criterion (PEC) values compared to circular tubes. However, the benefit diminishes at higher Re, with less than 10 % PEC increase. Implementing counter-current twisted tube configurations leads to approximately 13 % higher Nusselt number and 11 % higher Resistance factor, resulting in a 10 % overall PEC improvement. These findings highlight the superior thermal-hydraulic performance of twisted tubes in HCHE applications, especially at lower Reynolds numbers. Future work could explore different fluids, advanced optimization, energy analysis, cost assessment, and additional geometric parameters to further enhance twisted tube heat exchanger design and performance.