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Objective: The objective of this study is to determine the pooled prevalence of active trachoma among 1-9 years old children in Ethiopia., Design: A systematic review and meta-analysis were employed in accordance with the Preferred Reporting Items for Systematic Reviews., Data Sources: Medline/PubMed, Scopus, Web of Science, African Journal of Online and Google scholar databases were systematically explored to find studies published in English until July 2023., Eligibility Criteria: The following criteria apply: (1) condition (Co): studies examined the prevalence of trachoma among children (1-9) years old; (2) context (Co): studies conducted in Ethiopia; (3) population (Pop): studies that were done among children (1-9) years old; (4) study type: observational studies and (5) language: studies published in English., Data Extraction and Synthesis: The data were extracted using a Microsoft Excel spreadsheet. DerSimonian-Laird random effect model was used to estimate the pooled prevalence of active trachoma among 1-9 years old children. Cochrane Q-tests and I 2 statistics were used across studies to assess heterogeneity. To identify possible publication bias, Egger's test was performed., Primary Outcome: Prevalence of active trachoma among children aged (1-9 years old)"., Results: Overall, a total of 42 articles with 235 005 study participants were included in the final analysis. The estimated pooled prevalence of active trachoma using random effect model was 24% (95% CI 20% to 27%). The subgroup analysis by region revealed that the highest prevalence of trachoma was 36% (95% CI 13% to 58%) in the Tigray region, and publication year revealed the prevalence of trachoma was decreasing from 32% to 19% after 2015., Conclusion: In this review, the pooled prevalence of active trachoma was found to be high in Ethiopia compared with WHO threshold level. This underscores the need for increased focus on high-risk age groups to decrease trachoma and to achieve the elimination of trachoma from the country by 2030., Competing Interests: Competing interests: The review was conducted without any personal or financial relationship that could lead to conflict., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)