This study estimates the global burden of epilepsy, including lifetime epilepsy (LTE) and active epilepsy (AE), using a meta-analytic approach. The median prevalence of LTE in developed countries was 5.8 per 1,000, compared to 15.4 per 1,000 in rural and 10.3 per 1,000 in urban areas of developing countries. For AE, the median prevalence was 4.9 per 1,000 in developed countries and 12.7 per 1,000 in rural and 5.9 per 1,000 in urban areas of developing countries. The estimated global burden of LTE was 6.8 million in developed countries and 45 million in rural and 17 million in urban areas of developing countries. For AE, the estimated burden was 5.7 million in developed countries and 17 million in rural and 10 million in urban areas of developing countries. These estimates suggest that AE is more prevalent in developing countries, particularly in rural areas. The study found that study characteristics such as location, age of participants, and study size significantly influenced prevalence estimates. The results indicate that there are systematic differences in reported prevalence estimates, which are partially explained by study characteristics. The study highlights the importance of considering these factors when interpreting prevalence data and emphasizes the need for further research to better understand the variability in epilepsy prevalence. The findings suggest that the global burden of epilepsy is higher than previously estimated, with a significant portion of cases in developing countries potentially benefiting from treatment. The study also notes that the prevalence of epilepsy varies widely between developed and developing countries, with higher rates in developing countries, particularly in rural areas. The study concludes that the global burden of epilepsy and the proportion of cases with active epilepsy are important considerations for public health policy and treatment planning.This study estimates the global burden of epilepsy, including lifetime epilepsy (LTE) and active epilepsy (AE), using a meta-analytic approach. The median prevalence of LTE in developed countries was 5.8 per 1,000, compared to 15.4 per 1,000 in rural and 10.3 per 1,000 in urban areas of developing countries. For AE, the median prevalence was 4.9 per 1,000 in developed countries and 12.7 per 1,000 in rural and 5.9 per 1,000 in urban areas of developing countries. The estimated global burden of LTE was 6.8 million in developed countries and 45 million in rural and 17 million in urban areas of developing countries. For AE, the estimated burden was 5.7 million in developed countries and 17 million in rural and 10 million in urban areas of developing countries. These estimates suggest that AE is more prevalent in developing countries, particularly in rural areas. The study found that study characteristics such as location, age of participants, and study size significantly influenced prevalence estimates. The results indicate that there are systematic differences in reported prevalence estimates, which are partially explained by study characteristics. The study highlights the importance of considering these factors when interpreting prevalence data and emphasizes the need for further research to better understand the variability in epilepsy prevalence. The findings suggest that the global burden of epilepsy is higher than previously estimated, with a significant portion of cases in developing countries potentially benefiting from treatment. The study also notes that the prevalence of epilepsy varies widely between developed and developing countries, with higher rates in developing countries, particularly in rural areas. The study concludes that the global burden of epilepsy and the proportion of cases with active epilepsy are important considerations for public health policy and treatment planning.