This systematic review and meta-regression analysis aimed to consolidate epidemiological data on severe periodontitis (SP) and generate consistent prevalence and incidence estimates for all countries, age groups, and sexes in 1990 and 2010. The review included 72 studies with 291,170 individuals aged 15 years or older from 37 countries. SP was the sixth most prevalent condition globally, with a static age-standardized prevalence of 11.2% in 1990 and 2010. The age-standardized incidence rate in 2010 was 701 cases per 100,000 person-years, showing a nonsignificant increase from 1990. Prevalence increased gradually with age, peaking around 38 years of age. Geographic variations were evident, with countries like Chile, Brazil, Kenya, Indonesia, Australia, and Greece having higher prevalence rates than the global mean. The findings highlight the growing public health challenge posed by SP due to increasing life expectancy and decreasing tooth loss prevalence.This systematic review and meta-regression analysis aimed to consolidate epidemiological data on severe periodontitis (SP) and generate consistent prevalence and incidence estimates for all countries, age groups, and sexes in 1990 and 2010. The review included 72 studies with 291,170 individuals aged 15 years or older from 37 countries. SP was the sixth most prevalent condition globally, with a static age-standardized prevalence of 11.2% in 1990 and 2010. The age-standardized incidence rate in 2010 was 701 cases per 100,000 person-years, showing a nonsignificant increase from 1990. Prevalence increased gradually with age, peaking around 38 years of age. Geographic variations were evident, with countries like Chile, Brazil, Kenya, Indonesia, Australia, and Greece having higher prevalence rates than the global mean. The findings highlight the growing public health challenge posed by SP due to increasing life expectancy and decreasing tooth loss prevalence.