Background: Dysgeusia is a frequent yet underrecognised complication among head and neck cancer (HNC) patients, adversely affecting nutritional intake, psychological well-being and quality of life. Accurate prevalence estimates are essential to guide supportive care interventions. Objective: This meta-analysis aimed to determine the global pooled prevalence of dysgeusia in HNC patients and identify potential moderators influencing prevalence estimates. Materials and Methods: A systematic review and meta-analysis was conducted following MOOSE and PRISMA 2020 guidelines. Online databases were searched in March 2024 across Embase, PubMed and Scopus without restrictions on region, language, or publication year. Eligible studies reported prevalence of dysgeusia using subjective or objective assessments. Pooled prevalence was estimated using a generalised linear mixed model with a random-effects approach. Heterogeneity was assessed with I2 and Q statistics. Moderator analyses explored sources of heterogeneity. Results: Twenty-three studies involving 4805 HNC patients (mean age 59.8 ± 13.1 years) were included. The pooled prevalence of dysgeusia was 42.7% (95% CI, 29.7–56.9; n = 2099). Sensitivity analyses confirmed the robustness of these findings. The highest prevalence was observed in Asia (52.7%), followed by North America (41.4%) and South America (37.5%). Moderator analysis showed that older age, male sex, advanced disease stage (III–IV) and the use of diverse measurement tools significantly moderated the pooled prevalence of dysgeusia. Conclusions: Dysgeusia affects approximately half of HNC patients. Incorporating routine screening and targeted management of dysgeusia into survivorship care may help reduce nutritional risks, improve quality of life and support long-term rehabilitation. Clinical Significance: Dysgeusia is highly prevalent in HNC patients, with important implications for nutrition, adherence to treatment and psychosocial well-being. Routine assessment and evidence-based interventions for dysgeusia should be integrated into multidisciplinary oral rehabilitation programmes to optimise patient outcomes. © 2026 John Wiley & Sons Ltd.