Background <p>Late presentation of HIV among older adults challenges the “End AIDS by 2030” target, posing devastating consequences of individual health outcomes and increasing the burden on social health systems. While Asia faces the double burden of HIV aging and population aging, evidence on late presentation remains fragmented and lacks contextual relevance.</p> Aims <p>We aim to summarize the prevalence of late presentation of HIV and its associated factors in older people living with HIV in Asia.</p> Method <p>The protocol will follow the 2015 Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. We will search six international databases and three Chinese language databases. Observational studies reporting the prevalence of late presentation of HIV in older adults in Asia will be included. Study quality will be assessed using the Joanna Briggs Institute Critical Appraisal tools. Data will be analyzed using Stata 18, with meta-analysis, meta-regression and subgroup analyses conducted as appropriate.</p> Discussion <p>This study will synthesize evidence on the prevalence of late presentation among older people living with HIV in Asia. Our findings will clarify the status and risk factors of late presentation in older people living with HIV in Asia, offering insights to guide targeted strategies and policy response.</p> Systematic review registration <p>PROSPERO CRD42024618152.</p>