question: BACKGROUND: The prevalence of COVID-19 is different in studies conducted in different countries. The aim of this systematic review and meta-analysis is to estimate the pooled prevalence of COVID-19 in patients with MS. METHODS: Two independent researchers independently searched PubMed, Scopus, EMBASE, Web of Science, and google scholar along with gray literature up to April 2021. The search strategy included the MeSH and text words as (((coronavirus OR Wuhan coronavirus OR novel coronavirus OR coronavirus disease OR COVID-19 OR 2019 novel coronavirus infection OR 2019-nCOV OR severe acute respiratory syndrome coronavirus 2 OR SARS-CoV-2) AND (Multiple Sclerosis OR Sclerosis, Multiple) OR Sclerosis, Disseminated) OR Disseminated Sclerosis) OR MS (Multiple Sclerosis)) OR Multiple Sclerosis, Acute Fulminating). RESULTS: We found 1466 articles by literature search, and after deleting duplicates, 1029 remained. Twelve articles remained for meta-analysis. Totally, 101,462 patients were evaluated and the total number of possible/confirmed cases was 1394. Mean age ranged from 35 to 54 years. Totally, 49 patients died. The pooled prevalence of suspected COVID-19 in MS patients was 4% (95% CI: 3-4%) (I2 = 98.5%, P < 0.001). The pooled prevalence of hospitalization in infected cases was 10% (95% CI: 7-12%) (I2 = 95.6%, P < 0.001). The pooled prevalence of death in hospitalized cases was 4% (95% CI: 1-6%) (I2 = 82.4%, P < 0.001). CONCLUSION: Hospitalization rate is higher among MS patients based on COVID-19 infection while the pooled infection rate is estimated as 4%.