The study updates the global burden of cholera in endemic countries, addressing limitations of previous estimates that relied solely on reported cases. Using a spatial regression model, the authors classified countries as endemic, non-endemic, or cholera-free based on access to improved sanitation and water sources, as well as neighboring country cholera incidence. The updated estimates suggest 2.86 million cases (range: 1.3-4.0 million) and 95,000 deaths (range: 21,000-143,000) annually in 69 endemic countries, with Sub-Saharan Africa accounting for 60% of the cases. The findings highlight the need for integrated and improved control efforts to address the high burden of cholera, particularly in these regions. The study also provides valuable data for programmatic decision-making and vaccine stockpile planning.The study updates the global burden of cholera in endemic countries, addressing limitations of previous estimates that relied solely on reported cases. Using a spatial regression model, the authors classified countries as endemic, non-endemic, or cholera-free based on access to improved sanitation and water sources, as well as neighboring country cholera incidence. The updated estimates suggest 2.86 million cases (range: 1.3-4.0 million) and 95,000 deaths (range: 21,000-143,000) annually in 69 endemic countries, with Sub-Saharan Africa accounting for 60% of the cases. The findings highlight the need for integrated and improved control efforts to address the high burden of cholera, particularly in these regions. The study also provides valuable data for programmatic decision-making and vaccine stockpile planning.