Background <p>Viral gastroenteritis is a significant public health concern in developing countries, primarily affecting children under five years. Human astrovirus (HAstV) is one of the key viral agents causing gastroenteritis. Despite the global recognition of HAstV as a causative agent of acute gastroenteritis, its impact on Asian populations, particularly among hospitalized children, is lacking. This systematic review and meta-analysis aimed at determining the prevalence of HAstV-associated acute gastroenteritis among hospitalized pediatric patients in Asia.</p> Method <p>This systematic review and meta-analysis was conducted following PRISMA Guidelines and registered with PROSPERO (ID CRD42024519527). A comprehensive literature search was performed on PubMed, Web of Science and Scopus databases for studies published between January 2000 and December 2023. Keywords related to astrovirus, prevalence, pediatric populations and hospitalization in Asia were used. A pre-designed Excel sheet was used for data extraction and the Joanna Briggs Institute critical appraisal tool was used for quality assessment. Generalized Linear Mixed Models with logit transformation were used to calculate the effect sizes.</p> Results <p>The analysis included 49 studies, encompassing data from various Asian countries. The pooled prevalence of HAstV in hospitalized pediatric patients due to acute gastroenteritis was 2.39%, highlighting the significant burden in Asia. Sub-group analysis revealed considerable difference in HAstV prevalence among Asian countries.</p> Conclusions <p>This systematic review and meta-analysis summarizes the prevalence of HAstV among hospitalized pediatric patients in Asia, highlighting the need for country-specific strategies to improve surveillance and diagnostics.</p> Graphical Abstract <p></p>