A systematic review and meta-analysis of functional disorders (FD) across Europe found an overall point prevalence of 8.78% (95% CI 7.61–10.10%). The highest prevalence was in Norway (17.68%, 95% CI 9.56–30.38%), while the lowest was in Denmark (3.68%, 95% CI 2.08–6.43%). Specific FD diagnoses included chronic pain (20.27%, 95% CI 16.51–24.63%), irritable bowel syndrome (IBS) (9.08%, 95% CI 7.31–11.22%), and chronic widespread pain (CWP) (8.45%, 95% CI 5.40–12.97%). The study included 136 studies from Northern Europe, Spain, and Italy, with most focusing on IBS, CWP, and chronic pain. Variability in prevalence rates was attributed to diagnostic criteria, assessment methods, and country-specific factors. The meta-analysis revealed significant heterogeneity, with publication bias and small-study effects noted. Despite these challenges, the findings highlight the high prevalence of FD across Europe, emphasizing the need for standardized diagnostic criteria and improved care pathways. The study underscores the importance of addressing FD in healthcare systems, particularly in primary care, and highlights the need for further research to reduce variability in prevalence estimates and improve diagnostic accuracy.A systematic review and meta-analysis of functional disorders (FD) across Europe found an overall point prevalence of 8.78% (95% CI 7.61–10.10%). The highest prevalence was in Norway (17.68%, 95% CI 9.56–30.38%), while the lowest was in Denmark (3.68%, 95% CI 2.08–6.43%). Specific FD diagnoses included chronic pain (20.27%, 95% CI 16.51–24.63%), irritable bowel syndrome (IBS) (9.08%, 95% CI 7.31–11.22%), and chronic widespread pain (CWP) (8.45%, 95% CI 5.40–12.97%). The study included 136 studies from Northern Europe, Spain, and Italy, with most focusing on IBS, CWP, and chronic pain. Variability in prevalence rates was attributed to diagnostic criteria, assessment methods, and country-specific factors. The meta-analysis revealed significant heterogeneity, with publication bias and small-study effects noted. Despite these challenges, the findings highlight the high prevalence of FD across Europe, emphasizing the need for standardized diagnostic criteria and improved care pathways. The study underscores the importance of addressing FD in healthcare systems, particularly in primary care, and highlights the need for further research to reduce variability in prevalence estimates and improve diagnostic accuracy.