ObjectiveTo estimate the pooled prevalence of sexual dysfunction (SD) in women with multiple sclerosis (MS).MethodsWe systematically searched PubMed, Scopus, EMBASE, Web of Science, and google scholar and also gray literature up to October 2021.The search strategy includes:(“Multiple Sclerosis” OR “MS” OR “Disseminated Sclerosis” OR (Disseminated AND Sclerosis) OR (Sclerosis AND Multiple)) AND (“Sexual Dysfunction” OR (Sexual AND Dysfunction) OR (Sexual AND Dysfunctions) OR (Sexual AND Disorders) OR (Sexual AND Disorder) OR “Sexual Dysfunctions” OR “Sexual Disorders” OR “Sexual Disorder” OR “Psychosexual Dysfunctions” OR (Dysfunction AND Psychosexual) OR (Dysfunctions AND Psychosexual) OR “Psychosexual Dysfunction” OR “Psychosexual Disorders” OR (Disorder AND Psychosexual) OR (Disorders AND Psychosexual) OR “Psychosexual Disorder” OR “Hypoactive Sexual Desire Disorder” OR “Sexual Aversion Disorder” OR (Aversion Disorders AND Sexual) OR (Disorders AND Sexual Aversion) OR “Sexual Aversion Disorders” OR “Orgasmic Disorder” OR (Disorders AND Orgasmic) OR “Orgasmic Disorders” OR “Sexual Arousal Disorder” OR (Arousal Disorders AND Sexual) OR (Disorders AND Sexual Arousal) OR “Sexual Arousal Disorders” OR “Frigidity”).ResultsWe found 2150 articles by literature search, after deleting duplicates 1760 remained. Fifty-six articles remained for meta-analysis. The pooled prevalence of SD in MS patients estimated as 61% (95%CI:56–67%) (I2:95.7%,P< 0.001). The pooled prevalence of Anorgasmia in MS patients estimated as 29% (95%CI:20–39%) (I2:85.3%,P< 0.001). The pooled odds of developing SD in MS women estimated as 3.05(95%CI: 1.74–5.35) (I2:78.3%,P< 0.001). The pooled prevalence of decreased vaginal lubrication in MS patients estimated as 32%(95%CI:27–37%) (I2= 94.2%,P< 0.001). The pooled prevalence of reduced libido was 48%(95%CI:36–61%) (I2:92.6%,P< 0.001). The pooled prevalence of arousal problems was 40%(95%CI: 26–54%) (I2:97.4%,P< 0.001). The pooled prevalence of intercourse satisfaction was 27% (95%CI: 8–46%) (I2:99%,P< 0.001).ConclusionThe result of this systematic review and meta-analysis show that the pooled prevalence of SD in women with MS is 61% and the odds of developing SD in comparison with controls is 3.05.