This study aims to estimate the global burden of lifetime epilepsy (LTE) and active epilepsy (AE) and to examine the influence of study characteristics on prevalence estimates. A systematic review and meta-analysis were conducted using data from 65 studies, including both retrospective and prospective population-based studies from developed and developing countries. The median LTE prevalence was 5.8 per 1,000 in developed countries and 15.4 per 1,000 in rural areas and 10.3 per 1,000 in urban areas in developing countries. The median AE prevalence was 4.9 per 1,000 in developed countries and 12.7 per 1,000 in rural areas and 5.9 per 1,000 in urban areas in developing countries. The estimated median number of people with LTE in developed countries was 6.8 million, and in developing countries, it was 45 million in rural areas and 17 million in urban areas. The estimated median number of people with AE in developed countries was 5.7 million, and in developing countries, it was 17 million in rural areas and 10 million in urban areas. The study found that studies involving all ages or only adults showed higher estimates than pediatric studies, and higher prevalence estimates were associated with rural location and small study size. The results highlight the need for better data collection methods and more comprehensive studies to accurately estimate the global burden of epilepsy and the number of people who could benefit from treatment.This study aims to estimate the global burden of lifetime epilepsy (LTE) and active epilepsy (AE) and to examine the influence of study characteristics on prevalence estimates. A systematic review and meta-analysis were conducted using data from 65 studies, including both retrospective and prospective population-based studies from developed and developing countries. The median LTE prevalence was 5.8 per 1,000 in developed countries and 15.4 per 1,000 in rural areas and 10.3 per 1,000 in urban areas in developing countries. The median AE prevalence was 4.9 per 1,000 in developed countries and 12.7 per 1,000 in rural areas and 5.9 per 1,000 in urban areas in developing countries. The estimated median number of people with LTE in developed countries was 6.8 million, and in developing countries, it was 45 million in rural areas and 17 million in urban areas. The estimated median number of people with AE in developed countries was 5.7 million, and in developing countries, it was 17 million in rural areas and 10 million in urban areas. The study found that studies involving all ages or only adults showed higher estimates than pediatric studies, and higher prevalence estimates were associated with rural location and small study size. The results highlight the need for better data collection methods and more comprehensive studies to accurately estimate the global burden of epilepsy and the number of people who could benefit from treatment.