<p>Electronic cigarette (e-cigarette) use is increasing globally, yet comprehensive prevalence data for Latin America and the Caribbean (LAC) remain limited. We conducted a meta-analysis to estimate the prevalence of e-cigarette use in the LAC region. A comprehensive search was performed in PubMed/Medline, Scopus, Web-of-Science, Embase, SciELO and Virtual-Health-Library, from inception to January 2025. We included observational studies reporting the prevalence of e-cigarette use in the general population of LAC. Pooled prevalence estimates and corresponding 95% confidence intervals (95%CI) were calculated using random-effects meta-analysis models. A total of 82 studies were included, comprising 46 primary studies and 36 reports from international tobacco-related surveys. Lifetime e-cigarette use was highest among adolescents, with a pooled prevalence of 12.5% (95%CI: 9.1%–17.0%; I²=99.5%), compared with 6.4% (95%CI: 2.8%–14.1%; I²=97.5%) in adults. Current e-cigarette use was also most prevalent among adolescents (6.7%; 95%CI: 5.5%–8.3%; I²=99.2%), compared with adults (1.5%; 95%CI: 0.8%–2.9%; I²=98.9%). Adolescent current use varied geographically, ranging from 1.4% (El Salvador) and 2.5% (Mexico) to 14.5% (Jamaica) and 17.2% (Trinidad and Tobago). Meta-regression analysis showed a significant increasing temporal trend in e-cigarette use, with prevalence rising by 0.10% per year (95%CI: 0.01–2.0; <i>p</i> = 0.047), independent of age group. Despite heterogeneity across countries, the prevalence of e-cigarette use in LAC is high, particularly among adolescents, and has increased significantly over time. These findings indicate that e-cigarette use represents a growing public health concern in the region, calling for strengthened regulation, targeted youth prevention, and continuous surveillance.</p>