Background <p>Tuberculosis (TB) in cattle negatively affects the cattle economy in Africa, with zoonotic TB posing drug-resistance issues in humans. The burden of TB in cattle and zoonotic TB in humans in sub-Saharan Africa (SSA) is not well understood. This study aimed to determine the prevalence of both TB in cattle and zoonotic TB in humans in SSA through meta-analysis.</p> Methods <p>Research on TB prevalence was sourced from multiple databases. A random effects meta-analysis model estimated TB prevalence in SSA and its regions, while meta-regression identified risk factors. The analysis included 114 studies for cattle and 59 for humans.</p> Results <p>The estimated TB prevalence in cattle was 5.06% (95% CI: 3.76–6.78), with a higher burden in West Africa. The prevalence was greater on farms than at abattoirs. Among humans, <i>M. bovis</i> prevalence was 0.73% (95% CI: 0.53–1.01), increasing to 1.56% (95% CI: 1.04–2.33) in TB incident cases, especially in the West and East Africa. Higher prevalence was noted among livestock workers, and in drug-resistant cases. Significant factors influencing TB prevalence varied for cattle and humans, including country, diagnostic methods, and study populations.</p> Conclusion <p>Focusing interventions on farms and livestock workers could help reduce the disease burden.</p>