Node.js continues to be a dominant force in backend development due to its speed, scalability, and vast ecosystem. To build efficient Node.js applications in 2024, developers should focus on best practices such as structuring code in a modular fashion, using asynchronous programming effectively, and handling errors gracefully. Using tools like ESLint to enforce code standards and adhering to the twelve-factor app methodology can enhance maintainability and scalability. Additionally, optimizing database queries, implementing caching strategies, and using lightweight frameworks such as Express.js can boost performance. Proper logging and monitoring are crucial to detect issues early and ensure smooth operation in production environments.