This study provides an updated global burden of cholera in endemic countries. Previous estimates were based on reported cases, which led to misclassification of some countries. The authors used a spatial regression model to define endemic countries based on access to improved water and sanitation and cholera incidence in neighboring countries. They found that approximately 1.3 billion people are at risk for cholera in endemic countries. An estimated 2.86 million cholera cases occur annually in endemic countries, with an uncertainty range of 1.3 million to 4.0 million. Among these cases, there are an estimated 95,000 deaths annually, with an uncertainty range of 21,000 to 143,000. Sub-Saharan Africa accounts for the majority of the burden. The findings highlight the need for integrated and improved control efforts to address the high burden of cholera. The study also addresses limitations of previous estimates, including the use of a spatial model to better define endemic countries. The results are important for public health decision-making and vaccine stockpile planning. The study shows that the global burden of cholera remains high, and efforts for an integrated approach to cholera control are vital to prevent further spread of the disease and mitigate its impact.This study provides an updated global burden of cholera in endemic countries. Previous estimates were based on reported cases, which led to misclassification of some countries. The authors used a spatial regression model to define endemic countries based on access to improved water and sanitation and cholera incidence in neighboring countries. They found that approximately 1.3 billion people are at risk for cholera in endemic countries. An estimated 2.86 million cholera cases occur annually in endemic countries, with an uncertainty range of 1.3 million to 4.0 million. Among these cases, there are an estimated 95,000 deaths annually, with an uncertainty range of 21,000 to 143,000. Sub-Saharan Africa accounts for the majority of the burden. The findings highlight the need for integrated and improved control efforts to address the high burden of cholera. The study also addresses limitations of previous estimates, including the use of a spatial model to better define endemic countries. The results are important for public health decision-making and vaccine stockpile planning. The study shows that the global burden of cholera remains high, and efforts for an integrated approach to cholera control are vital to prevent further spread of the disease and mitigate its impact.