Visceral leishmaniasis (VL) is a protozoan disease caused by some Leishmania donovani complex species and is considered as an endemic zoonotic parasitic disease in Iran. This study was performed to determine the prevalence of human VL in Iran. Data were systematically gathered from 1985 to 2018 in Islamic republic of Iran from the following electronic databases: PubMed, Google Scholar, Science Direct, Scopus, Web of Science, Magiran, Irandoc, Iranmedex and Scientific Information Database (SID). In total, 29 studies reporting the prevalence of VL from different areas of Iran met our suitability criteria. The Q test and the I2 statistics were applied to determine heterogeneities. The Egger’s and Begg’s test was used to check the presence of publication bias. The pooled prevalence of VL in Iran measured by random-effects was estimated at 1% (95% CI:1 - 2) in urban areas, 3% (95% CI:2 - 4) in rural areas and 2% (95% CI: 2-3) in total. The majority of VL cases during the last 33 years were reported in the northwest and south provinces of Iran. There was a high degree of heterogeneity (I2 = 98.2%, Q test: p = 0.0002) and Begg’s (z = 3.62, p < 0.001) and Egger’s (bias = 5.9, 95% CI = 2.70 - 9.11) tests were significant for the study of publication bias. After correction, the total prevalence was estimated to be 0.3% (95% CI: 0.2 - 0.9). The prevalence of VL in Iran was 0.3%, and this rate was much higher in the northwest and south of the country. These results are desirable for managing the control programs of this disease.
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