OBJECTIVES: Varicella is a common and vaccine-preventable disease, but its impact on public health in Eastern Europe (EE) has received little attention. This study aimed to review the epidemiology and economic burden of varicella in EE.  METHODS: A systematic literature review was conducted in PubMed and government websites to identify published data on epidemiology and economic burden of varicella in EE. Extracted study data included varicella incidence, complications, mortality, vaccination program availability and coverage rates, as well as healthcare resource utilization and medical costs associated with varicella. Critical analyses of study quality and data gaps were analyzed at the country level.  RESULTS: Published varicella data were identified from fourteen countries including Bosnia Herzegovina, Bulgaria, Croatia, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Russia, Serbia, Slovakia, and Slovenia. Only Latvia has a universal varicella vaccination program, while the remaining countries either only recommend varicella vaccination for high-risk individuals or have no recommendations. The annual incidence of varicella in EE ranged from 164 per 100,000 in Latvia to 481 per 100,000 in Poland. Hospitalization rates associated with varicella ranged from 1 per 1,000 cases in Estonia to 30 per 1,000 cases in Latvia. Frequent complications among hospitalized patients included respiratory, skin, hematologic, and neurologic complications. Mortality rates ranged from 0-20 per 100,000 cases in Poland, Serbia, and Slovenia. Varicella incidence peaked in winter in Poland and Slovenia. No data on direct and indirect costs of varicella in EE was available. Overall, Poland and Slovenia had the most data on burden of varicella while limited data existed for the remaining countries.  CONCLUSIONS: Epidemiologic and economic burden of varicella in EE have not been extensively studied. Given limited varicella vaccination policy in this region, gaps in evidence need to be addressed to inform policy makers about the public health impact on varicella.