OBJECTIVES: Essential Tremor (ET) is the most common neurologic movement disorder and it is associated with physical and cognitive impairments, avoidance of social settings, and related difficulties that negatively impact the lives of patients. We conducted a systematic review and meta-analysis to quantify the overall prevalence of ET and to describe the disease burden and unmet needs of patients with ET. METHODS: We conducted an electronic search of the literature using PubMed, Embase and the Cochrane Library databases until May 2017. We included studies reporting the prevalence of ET between 2000-2017. Studies reporting disease burden and unmet needs of patients with ET were identified. The prevalence of ET was pooled using random effects model. RESULTS: Thirty-one studies reported the prevalence of ET and the pooled prevalence was 2.41% (95% CI 1.58, 3.40%). The estimated prevalence for persons ≥65 years was 3.57% (95% CI 2.57, 5.14%). Prevalence in the US was 4.65% (95% CI 1.87, 8.58) while prevalence in Europe was 3.89 (95% CI 2.16, 6.11). The validated Quality of Life in Essential Tremor Questionnaire (QUEST) is the only disease specific questionnaire for ET. Although, ET is more common in the elderly, Quality of life is impaired even in younger patients with ET and psychosocial domain is the most affected. Propranolol and primidone are the first line drugs used for the treatment of ET and has the most robust clinical evidence. About 30% of patients with ET will not respond to either propranolol or primidone. CONCLUSIONS: The prevalence of ET is increasing and there is an unmet need for a safe and effective treatment of patients with ET. It is hoped that current drugs in development will help meet this unmet need and alleviate the economic and health-related quality of life burden suffered by ET patients.