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Aim To determine the prevalence of extended-spectrum β-lactamase (ESBL) and metallo-β-lactamase (MBL)-producing Escherichia coli in South Asia. Methodology A systematic review and meta-analysis of data published in PubMed, EMBASE, Web of Science and Scopus. Results The pooled prevalence of ESBL and MBL-producing E. coli in South Asia were 33% (95% CI 27-40%) and 17% (95% CI 12-24%), respectively. The prevalence of blaCTX-M type was 58% (95% CI 49-66%) with blaCTX-M-15 being the most prevalent (51%, 95% CI 40-62%) variant. The most pre