Background: Cryptococcal meningitis (CM) is one of the most important HIV-related opportunistic infections, especially in the developing world, where overall mortality is very high. In order to help develop global strategies for prevention and treatment, it is important to estimate the burden of CM. Methods: We searched the English literature for studies reporting an estimate of CM among HIV populations. The median CM incidence of each UNAIDS geographic region was multiplied by the HIV population to estimate the region-specific CM cases. The range of cases in each region was calculated as ± one standard deviation from the regional estimate, using a median coefficient of variation across the regions. To estimate deaths, we assumed the 3-month case-fatality rate in high-income regions to be 9%, 55% in low- and middle-income regions, and 70% in Sub-Saharan Africa, based on available literature and expert opinion. Results: Of over 9,000 abstracts reviewed, 19 studies met the search criteria; yearly incidence ranged from 0.04%-12% among persons with HIV. Sub-Saharan Africa had the highest estimate (median incidence 3.2%, 720,000 cases, range, 144,000 - 1.3 million), followed by South/ Southeast Asia (median incidence 3.0%, 120,000 cases, range, 24,000 - 216,000). Median incidence was lowest in Western and Central Europe and Oceania (<0.1% each). Globally, approximately 957,900 cases (range, 371,700 - 1,544,000) of CM occur each year, resulting in 624,700 deaths (range, 125,000 - 1,124,900) by 3 months after infection. Conclusions: This study, the first attempt to estimate the global burden of CM, confirms the high burden of CM, particularly in Sub-Saharan Africa and South/ Southeast Asia. Further work is needed to better define and track the epidemiology of this infection, in order to prioritize prevention, diagnosis, and treatment strategies.