<p>Pain is the most important and burdensome complaint reported in individuals with hidradenitis suppurativa (HS), greatly affecting their quality of life. The frequency and intensity of pain in HS patients can vary, influenced by disease severity, lesion distribution, and accompanying health conditions. The aim of this systematic review and meta-analysis was to estimate the prevalence of reported pain in adult patients with HS in clinic-based settings. Using PRISMA criteria, PubMed and Embase were searched for observational and clinic-based studies reporting pain experiences in HS, with HS pain defined as any occurrence of pain ever experienced. Two independent investigators screened titles, abstracts, and full-text articles. A random-effects meta-analysis was conducted to estimate the pooled relative frequency of pain reported among patients with HS across clinic-based studies. Fourteen clinic-based studies were identified. Of these, total of 6 reported prevalence of pain in adult patients with HS (<i>n</i> = 3292). The pooled prevalence of pain was found to be 88.7% with 95% CI (81.9–93.2%). Considerable heterogeneity was noted across studies (I² =94.1%). Pain is a frequent complaint among patients with HS. The considerable heterogeneity among the studies highlights the need for consistent measurement approaches which could improve our understanding of the impact of pain in this population.</p>