ObjectiveTo systematically review the prevalence of osteoarthritis in Chinese aged 40 and above from January 2000 to December 2019.MethodsPubMed, ScienceDirect, Wiley Online Library, The Cochrane Library, CBM, VIP, CNKI and WanFang Data databases were electronically searched to collect cross-sectional studies on osteoarthritis in Chinese aged 40 and above from January 1st, 2000 to December 31st, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed using R 3.5.2 software.ResultsA total of 29 cross-sectional studies with a total sample of 60 711 cases and 19 707 patients were included. The results of meta-analysis showed that, the crude prevalence of osteoarthritis in Chinese aged 40 and over was 38.46% (95%CI 24.31% to 46.22%). Subgroup analysis results showed that the prevalence of lumbar osteoarthritis was the highest (24.79%, 95%CI 13.28% to 27.37%), followed by knee osteoarthritis prevalence (20.50%, 95%CI 14.51% to 27.23%) which increased with age. The prevalence of knee osteoarthritis in females (25.14%, 95%CI 19.54% to 31.19%) was higher than that in males (18.99%, 95%CI 13.86% to 24.71%). The prevalence of knee and lumbar osteoarthritis in rural areas was higher than that in urban areas. The prevalence of knee osteoarthritis in western China (23.59%, 95%CI 18.34% to 30.35%) was higher than that in eastern China (18.36%, 95%CI 12.43% to 27.92%) and central China (15.54%, 95%CI 11.22% to 21.53%). The prevalence of lumbar osteoarthritis in western China (31.17%, 95%CI 19.21% to 50.60%) was higher than that in eastern China (24.38%, 95%CI 16.26% to 36.54%). The incidence of cervical osteoarthritis in the eastern China (20.49%, 95%CI 13.90% to 30.21%) was higher than that in the western China (12.32% 95%CI 8.09% to 18.75%). The prevalence of hand osteoarthritis in western China (6.85%, 95%CI 2.71% to 8.13%) was higher than that in eastern China (2.7%, 95%CI 1.33% to 5.48%).ConclusionsCurrent evidence shows that the prevalence of osteoarthritis in Chinese aged 40 and above is high, and the prevalence of lumbar osteoarthritis is the highest, and the prevalence in western China is higher than that in eastern and central China, followed by knee osteoarthritis, in which the prevalence in females, rural areas, and western China is high. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.