Objective <p>This study aims to provide a comparative investigation between international and Chinese epidemiology of recurrent pericarditis (RP), highlighting the data gap in China and providing important evidence for further research on RP prevention and treatment.</p> Methods <p>We conducted a comprehensive analysis of RP epidemiological data from the inception of each database up to September 30, 2024 through systematic literature review and meta-analysis (PROSPERO registration: CRD42024595678). Additionally, to address the lack of epidemiological data in China, we conducted a survey using medical record systems from healthcare institutions in selected regions of China, to estimate the same epidemiological data for RP in Shandong Province, Shaanxi Province, and Guangzhou City from 2017 to 2021.</p> Results <p>Based on international literature estimates, the incidence rate range of RP in China is 42.50–54.80/1,000,000 person-years, with a prevalence of approximately 112.00/1,000,000. Accordingly, it is estimated that there are about 60,000–77,000 new RP cases annually in China from 2021 to 2023, with approximately 158,000 existing patients. In contrast, our medical record research found that the incidence rate range of RP in the three Chinese regions was 0.074–0.366/1,000,000 person-years, with a prevalence range of 0.158–1.512/1,000,000, significantly lower than the estimates based on international data.</p> Conclusion <p>This is the first systematic review contextualizing RP epidemiology in China against international data. Our findings indicate that available regional data from China report a much lower incidence and prevalence of RP than international estimates. We emphasize the urgent need for more comprehensive epidemiological investigations in China to support clinical practice and policy-making and ultimately improve management and outcomes for RP patients.</p>