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Cystic echinococcosis (CE) is a cestode infection of significant public health and economic importance. A systematic review and meta-analysis was performed to estimate the pooled prevalence of small ruminant CE and associated risk factors in Ethiopia. The published literature written in English from 01 January 2000 to 30 December 2019 was searched from electronic databases and eligible reports that fulfilled inclusion and exclusion criteria. A total of 1140 records were identified, of which 23 reports met the eligibility criteria. A random-effects meta-analysis model was used to pool the prevalence estimations, and a subgroup meta-analysis was utilized to compare the pooled prevalence of CE among the species, age group and sex of the studied animals. The pooled estimated small ruminant CE prevalence was 20.5% (95% confidence interval [CI]: 18.7, 22.3) in Ethiopia, and there was significant heterogeneity among the studies (p < 0.05). The pooled prevalence was higher for sheep, 24.3% (18.5, 30.1), compared to goats, 18.5% (14.5, 22.6), and in adults than young animals. The results of the present analysis suggested a high prevalence of CE at the national level. CE has a significant economic impact due to organ condemnation and production losses and poses a serious public health risk. Effective control requires public awareness, improved slaughterhouse practices, stray dog population management and integrated surveillance and control programmes involving veterinary, public health and environmental sectors. Such synthesis reports are believed to be useful in influencing policymakers towards designing effective prevention and control policies and strategies., (© 2024 The Author(s). Veterinary Medicine and Science published by John Wiley & Sons Ltd.)