Background <p>Meditation use has grown significantly in recent decades. However, population prevalence data is largely absent in Australasia.</p> Methods <p>We surveyed adults in Australia (<i>n</i> = 2,072) and New Zealand (<i>n</i> = 571) in 2023, using census-informed quotas for age, gender, ancestry/ethnicity, region and income. We calculated lifetime and past year meditation use estimates and conducted univariable analyses and multivariable logistic regression to investigate predictive factors.</p> Results <p>We estimate that 41.5% of Australian (~ 8.6&#xa0;M) and 35.7% of New Zealand (~ 1.5&#xa0;M) adults have ever used meditation, while 32.8% (6.8&#xa0;M) and 24.9% (1.0&#xa0;M), respectively, used meditation in the past year. In multivariable regression, younger age and higher education were consistent predictors of past-year meditation use in both countries. In Australia, additional predictors included female gender, Aboriginal or Torres Strait Islander ancestry, unmet need for mental health care, and receipt of complementary care. In New Zealand, identifying as LGBTQIA + was a strong positive predictor, while not receiving medical care was associated with lower odds of meditation use. Over 21.7% of Australian (~ 1.5&#xa0;M) and 17.6% of New Zealand meditators (~ 0.2&#xa0;M) experienced a meditation-related adverse effect.</p> Conclusions <p>Based on currently available data from a limited number of countries, Australia and New Zealand appear to have relatively high rates of meditation use, with meditation being used as an adjunct and/or alternative to mental health services. There is a need for more research into specific meditation practices and their application to mental health. Clinical guidelines on best-practice for meditation use would help to maximise benefits and minimise harms.</p> Clinical trial number <p>Not applicable.</p>