Background and Objectives: A nosocomial infection (NI) is defined as an infection occurring in a patient after 48 hours of hospitalization or up to 72 hours after discharge from the hospital, which was not present or incubating at the time of admission. NIs increase hospital mortality, decrease patient satisfaction, reduce hospital productivity, and increase health system costs. This study was conducted to determine the prevalence of NIs in Iranian hospitals. Methods: This study was performed using a systematic literature review and meta-analysis. Seven electronic databases and two search engines were searched using appropriate key words to identify research studies on NIs published in Persian and English languages from April 1997 to March 2019 in Iran. Finally, 15 empirical studies out of 89 records were reviewed. Data were analyzed using the Comprehensive Meta-Analysis software. Results: The studies reported a prevalence of 0. 32% to 9. 1% for NIs in Iranian hospitals. The pooled prevalence of NIs in Iranian hospitals was 0. 01 % (95% CI 0. 0%-0. 02%). The most common type of infection was urinary tract infection and the most common microorganism was Escherichia coli. The highest rate of nosocomial infections was seen in the intensive care unit, internal medicine ward and hematology ward. Suction was the most important risk factor for nosocomial infections. Conclusion: The prevalence of NIs in Iranian hospitals is low according to the published studies. Appropriate strategies should be implemented to prevent and control NIs.