A systematic meta-analysis of existing literature was conducted to determine the prevalence of purulent vaginal discharge (PVD) and factors influencing global prevalence estimates. Four databases (PubMed, Google Scholar, Web of Science, and Scopus) were queried with keywords “endometritis,” “PVD,”and “dairy.” Abstracts of initial search results were scanned to ensure dairy cows and one of the 3 most common methods for PVD diagnosis (gloved hand, vaginoscopy, or Metricheck) were used. This resulted in collection of 42 manuscripts, 36 of which reported sufficient information about their methodology and PVD prevalence to be included in the analysis. Reports were from 5 geographic regions: North America, South America, Europe, Asia, and the South Pacific and included 85 observations on PVD prevalence. Proportion of population positively diagnosed with PVD ([0, 1]) was used as the measure of prevalence. The metafor package (Viechtbauer et al., 2010, J Stat. Softw. 36:1–48) in R statistical software was used to fit fixed, random, and mixed effects models to estimate average PVD prevalence and factors influencing this prevalence using a logistic transformation of the original proportion values weighted by the number of animals in the cohort. The fixed effects model estimated a prevalence of 0.23 [95% (CI): 0.23–0.23] while the random effects model estimated a slightly higher effect size of 0.24 (95% CI: 0.21 – 0.28). The full mixed effects model included fixed effects for parity, calving strategy (seasonal or continuous), region of the world, method of diagnosis, and days in milk (DIM) at diagnosis. Only DIM at diagnosis had a significant (P = 0.07) effect on the prevalence of PVD with a decrease of 0.4% per day in lactation. Average PVD prevalence estimated by the mixed-effects model was 0.249 [95% CI: 0.20 – 0.30]. All models included a large degree of heterogeneity indicating factors not included here account for most of the variation in PVD; however, our results show PVD prevalence does not vary with region of the world, parity, or method of diagnosis.