This systematic review and meta-analysis aimed to determine the prevalence of the intention to receive the monkeypox (Mpx) vaccine. The study included 29 cross-sectional articles with a total sample of 52,658 participants from 19 countries. The pooled prevalence of intention to vaccinate against Mpx was 61% (95% CI: 53–69%). Subgroup analyses by continent showed higher intentions in Asian countries (64%), followed by American (63%), European (62%), and African (43%) countries. Among specific populations, healthcare workers had a higher intention (57%), while the LGBTI community had the highest intention (76%). The prevalence of refusal to vaccinate was 22% (95% CI: 16–30%). The study highlights regional and subgroup disparities in Mpx vaccine willingness and refusal, emphasizing the need for tailored communication and education strategies to enhance vaccination uptake and address concerns in high-refusal groups.This systematic review and meta-analysis aimed to determine the prevalence of the intention to receive the monkeypox (Mpx) vaccine. The study included 29 cross-sectional articles with a total sample of 52,658 participants from 19 countries. The pooled prevalence of intention to vaccinate against Mpx was 61% (95% CI: 53–69%). Subgroup analyses by continent showed higher intentions in Asian countries (64%), followed by American (63%), European (62%), and African (43%) countries. Among specific populations, healthcare workers had a higher intention (57%), while the LGBTI community had the highest intention (76%). The prevalence of refusal to vaccinate was 22% (95% CI: 16–30%). The study highlights regional and subgroup disparities in Mpx vaccine willingness and refusal, emphasizing the need for tailored communication and education strategies to enhance vaccination uptake and address concerns in high-refusal groups.