This study aimed to quantify the global prevalence of chronic obstructive pulmonary disease (COPD) through a systematic review and meta-analysis of population-based prevalence estimates published between 1990 and 2004. The review included articles that provided total population or sex-specific estimates for COPD, chronic bronchitis, and/or emphysema, with clear method details. Of the 67 accepted articles, 62 unique entries yielded 101 overall prevalence estimates from 28 different countries. The pooled prevalence of COPD was 7.6%, chronic bronchitis alone was 6.4%, and emphysema alone was 1.8%. Spirometric definitions, primarily those of the Global Initiative for Chronic Obstructive Lung Disease (GOLD), were used in 26 studies, with a pooled prevalence of 8.9%. Significant heterogeneity was observed, partly explained by subgroup analysis based on age, smoking status, and sex. The prevalence of physiologically defined COPD in adults aged ≥40 years was estimated at 9–10%. The study highlights regional gaps and methodological differences that hinder interpretation of the available data, emphasizing the need for standardized measurement approaches, such as those proposed by GOLD, to improve understanding of the global burden of COPD.This study aimed to quantify the global prevalence of chronic obstructive pulmonary disease (COPD) through a systematic review and meta-analysis of population-based prevalence estimates published between 1990 and 2004. The review included articles that provided total population or sex-specific estimates for COPD, chronic bronchitis, and/or emphysema, with clear method details. Of the 67 accepted articles, 62 unique entries yielded 101 overall prevalence estimates from 28 different countries. The pooled prevalence of COPD was 7.6%, chronic bronchitis alone was 6.4%, and emphysema alone was 1.8%. Spirometric definitions, primarily those of the Global Initiative for Chronic Obstructive Lung Disease (GOLD), were used in 26 studies, with a pooled prevalence of 8.9%. Significant heterogeneity was observed, partly explained by subgroup analysis based on age, smoking status, and sex. The prevalence of physiologically defined COPD in adults aged ≥40 years was estimated at 9–10%. The study highlights regional gaps and methodological differences that hinder interpretation of the available data, emphasizing the need for standardized measurement approaches, such as those proposed by GOLD, to improve understanding of the global burden of COPD.