The aim of this study was to estimate the pooled prevalence of water pipe smoking in university students in Iran. METHODS: We performed the literature search from 1946 to January 21, 2019, in several international and national databases such as Medline PubMed, Web of Science, Scopus, Google Scholar, Magiran, Iranmedex, and IranPsych. ...CONCLUSION: The higher prevalence rate of water pipe smoking among university students indicates the emergency need for planning preventive program....