Background: Tuberculosis remains a main public health concern in the world resulting in significant morbidity and mortality as well as in Ethiopia.

Objective: To produce pooled Magnitude on delay in diagnosis and treatment of tuberculosis patients and its determinants

Methods: The presence of similar topics with design was checked and the topic was registered on PROSPERO to prevent duplication. Published and unpublished studies conducted in Ethiopia since 2002 to April 1 2020 were searched thoroughly using electronic databases. Data were analyzed using STATA version 14. Heterogeneity was checked by using I² and Cochrane Q test. In the presence of heterogeneity, a random effect model was employed. Publication bias was checked by using the graphical funnel plot and Egger’s statistical test.

Result and discussion: The Pooled prevalence of tuberculosis diagnosis and treatment delay in Ethiopia was 45.42% [95%CI 34.44, 56.40], and 47.04% [95%CI 36.50, 57.59] respectively. Residing in urban, and patients with positive sero-status were protective against TB diagnostic delay while having extra-pulmonary TB and not married were risk factor. First visit of governmental health facility, and having pulmonary TB were protective against treatment delay.

Conclusion and recommendation: TB diagnosis and treatment in Ethiopia are significantly high. Sociodemographic and clinical factors were significantly contributing to the delay. Therefore, national TB control programs need to address gaps, barriers and weaknesses along the entire patient care, to improving appropriate diagnosis, linkages to treatment and strengthening both public and private healthcare sectors

Keywords: tuberculosis, delay in treatment, delay in diagnosis, Ethiopia