Abstract: Objective: To quantitatively estimate the epidemiological burden of bullous pemphigoid (BP) at global, regional, and national levels. Methods: A systematic search for epidemiological studies on BP was conducted. A Bayesian hierarchical linear mixed model was constructed to estimate the incidence and number of new cases globally, regionally, and in specific countries, with a descriptive summary of prevalence. Results: A total of 55 studies met the inclusion criteria. Model estimates indicated a global BP incidence of 17.75 (10.69-25.92) per million person-years, corresponding to approximately 143 628 (86 501-209 738) new cases annually. Incidence showed marked geographic variation. Regional estimates ranged from 1.19 (0.00-4.00) per million person-years in Southeast Asia to 28.05 (17.50-41.00) per million person-years in East Asia. At the national level, the United Kingdom had the highest incidence ［48.75（35.78~62.89) per million person-years］, while South Africa had the lowest ［1.13 (0.00-4.00) per million person-years］. The incidence in females was 1.22 times that in males ［23.85 (15.50-33.17) per million person-years vs. 19.48 (11.92-28.17) per million person-years］. Incidence in adults ［30.18 (21.13-40.47) per million person-years］ was significantly higher than in all-age populations ［14.26 (7.78-21.80) per million person-years］. Diagnostic method influenced the estimates: the incidence estimated by combined immunological and pathological diagnosis ［18.65 (11.38-27.00) per million person-years］ was higher than that estimated by immunological diagnosis alone ［11.92 (6.00~18.86) per million person-years］. Temporally, incidence reported in studies published during 2011-2025 ［18.23 (11.09~26.53) per million person-years］ was higher than in those published during 1975-2010 ［17.06 (10.10~25.04) per million person-years］. Prevalence also exhibited considerable geographic heterogeneity. Conclusion: Epidemiological data on BP are lacking for 85.78% of countries worldwide. The disease shows significant disparities in incidence across geography, sex, and age. Variability in diagnostic criteria affects incidence estimation, which underscores the need for a standardized global surveillance system. Furthermore, long-term trend analyses suggest a rising incidence over time.

Key words: bullous pemphigoid, epidemiology, bayesian hierarchical linear mixed-effects model