BackgroundTuberculosis is a bacterial infectious disease, which affects different parts of a human body, mainly lungs and can lead to the patient’s death. The aim of this study is to investigate the global prevalence of drug-resistant tuberculosis using a systematic review and meta-analysis.MethodsIn this study, the PubMed, Scopus, Web of Science, Embase, ScienceDirect and Google Scholar repositories were systematically searched to find studies reporting the global prevalence of drug-resistant tuberculosis. The search did not entail a lower time limit, and articles published up until August 2022 were considered. Random effects model was used to perform the analysis. The heterogeneity of the studies was examined with theI2test. Data analysis was conducted within the Comprehensive Meta-Analysis software.ResultsIn the review of 148 studies with a sample size of 318,430 people, theI2index showed high heterogeneity (I2= 99.6), and accordingly random effects method was used to analyze the results. Publication bias was also examined using the Begg and Mazumdar correlation test which indicated the existence of publication bias in the studies (P= 0.008). According to our meta-analysis, the global pooled prevalence of multi-drug resistant TB is 11.6% (95%CI: 9.1–14.5%).ConclusionsThe global prevalence of drug-resistant tuberculosis was found to be very high, thus health authorities should consider ways to control and manage the disease to prevent a wider spread of tuberculosis and potentially subsequent deaths.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40249-023-01107-x.