This systematic review and meta-analysis aimed to determine the prevalence of intention to receive the monkeypox (Mpox) vaccine. A total of 29 cross-sectional studies involving 52,658 participants were included. The pooled prevalence of intention to vaccinate against Mpox was 61% (95% CI: 53–69%). Subgroup analyses by continent showed varying rates: 64% in Asian countries, 43% in African countries, 62% in European countries, and 63% in American countries. Subgroup analyses by study population revealed 54% in the general population, 57% in healthcare workers, and 76% in the LGBTI community. Additionally, the prevalence of refusal to vaccinate against Mpox was 22% (95% CI: 16–30%). The study highlights regional and subgroup disparities in vaccine willingness and refusal, emphasizing the need for targeted strategies to improve vaccination coverage and public health outcomes globally. The findings suggest that vaccine hesitancy and refusal are significant challenges, particularly among certain populations. The study underscores the importance of understanding factors influencing vaccine acceptance and implementing effective communication and education strategies to enhance vaccination uptake. The results provide valuable insights for developing public health policies and interventions to address Mpox and other infectious diseases.This systematic review and meta-analysis aimed to determine the prevalence of intention to receive the monkeypox (Mpox) vaccine. A total of 29 cross-sectional studies involving 52,658 participants were included. The pooled prevalence of intention to vaccinate against Mpox was 61% (95% CI: 53–69%). Subgroup analyses by continent showed varying rates: 64% in Asian countries, 43% in African countries, 62% in European countries, and 63% in American countries. Subgroup analyses by study population revealed 54% in the general population, 57% in healthcare workers, and 76% in the LGBTI community. Additionally, the prevalence of refusal to vaccinate against Mpox was 22% (95% CI: 16–30%). The study highlights regional and subgroup disparities in vaccine willingness and refusal, emphasizing the need for targeted strategies to improve vaccination coverage and public health outcomes globally. The findings suggest that vaccine hesitancy and refusal are significant challenges, particularly among certain populations. The study underscores the importance of understanding factors influencing vaccine acceptance and implementing effective communication and education strategies to enhance vaccination uptake. The results provide valuable insights for developing public health policies and interventions to address Mpox and other infectious diseases.