Docker containerization for Node.js involves creating a Dockerfile that starts from a Node.js base image. You set a working directory inside the container, copy package.json files first, then run npm install to install dependencies. Next, you copy all your app files into the container. The CMD instruction tells Docker how to start your app, usually with 'node index.js'. You build the Docker image using 'docker build' and then run it with 'docker run', mapping the container's port to your host machine so you can access the app. This process isolates your app environment and makes it easy to run anywhere Docker is installed.