| Summary: | Tilapia has a high socioeconomic value in many countries worldwide. However, it has been identified as a zoonotic parasite reservoir. A systematic literature search and meta-analysis were carried out in order to estimate the global prevalence of zoonotic parasites that affect tilapia. The search was performed by three field experts to avoid reviewer bias. Polled prevalence was estimated using a logistic-normal random-effect regression model in the R software. We dealt with the heterogeneity among studies through subgroup analysis, taking into account the continent, country, genus of the host, parasite taxonomic group, sample origin, and type of diagnostic test as moderator variables. Fifty-two eligible articles were identified covering five tilapia genera with a pooled prevalence of 0.14 (95% CI: 0.10–0.20) showed significant heterogeneity (<i>I<sup>2</sup></i> = 98.4; <i>p</i> < 0.001). The subgroup analysis revealed that the most affected host was <i>Sarotherodon,</i> with a prevalence of 0.42 (95% CI: 0.22–0.65). Cestode was the taxonomic group with the largest prevalence (0.40; 95% CI:0.32–0.48), followed by amoeba (0.24; 95% CI: 0.16–0.35) and nematode (0.22; 95% CI: 0.11–0.38), among which, <i>Schyzocotyle</i> spp., <i>Opistorchis</i> spp., <i>Gnathostoma</i> spp. and <i>Vermamoeba</i> spp. have an impact on public health. Significant differences (<i>p</i> < 0.004) were found among continents and countries, with the highest value of prevalence detected in the African continent (0.28; 95% CI: 0.20–0.37), specifically in Tanzania (0.56; 95% CI: 0.22–0.87) and Egypt (0.43; 95% CI: 0.20–0.55). The origin of samples had a significant effect (<i>p</i> < 0.0001) on the detected prevalence, especially from those that showed the highest prevalence (0.24; 95% CI: 0.17–0.33). Finally, there were no differences in prevalence according to the diagnostic test (<i>p</i> = 0.97). Our results provide useful information on the development of epidemiological programs for the control of zoonoses associated with parasites in tilapia and in the design, planning, and implementation of future research.
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