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Background: Urinary schistosomiasis is a serious threat in endemic territories of Africa and the Middle East. The status of female urinary schistosomiasis (FUS) in published literature between 2016 and 2020 was investigated. Methods: A systematic search in PubMed, Scopus, Google Scholar, and Web of Science, based on the 'Preferred Reporting Items for Systematic Reviews and Meta-analyses' checklist, and a meta-analysis using random-effects model to calculate the weighted estimates and 95% confidence intervals (95% CIs) were done. Results: Totally, 113 datasets reported data on 40,531 women from 21 African countries, showing a pooled prevalence of 17.5% (95% CI: 14.8–20.5%). Most studies (73) were performed in Nigeria, while highest prevalence was detected in Mozambique 58% (95% CI: 56.9–59.1%) (one study). By sample type and symptoms, vaginal lavage [25.0% (95% CI: 11.4–46.1%)] and hematuria 19.4% (95% CI: 12.2–29.4%) showed higher FUS frequency. Studies using direct microscopy diagnosed a 17.1% (95% CI: 14.5–20.1%) prevalence rate, higher than PCR-based studies 15.3% (95% CI: 6.1–33.2%). Except for sample type, all other variables had significant association with the overall prevalence of FUS. Conclusions: More studies are needed to evaluate the true epidemiology of FUS throughout endemic regions. [ABSTRACT FROM AUTHOR]