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Background: Clinical features of rotavirus gastroenteritis vary from mild to severe and the prevalence of the disease is high in Eastern Mediterranean Region. The aim of this systematic review is to create solid evidence for the prevalence and clinical features of rotavirus among children under five years in Eastern Mediterranean Region. Methods: Several databases have been searched: MEDLINE, PubMed, ScienceDirect, google scholar and the Cochrane Library. In addition, the authors searched relevant organizations websites and, they went through grey literature search. A total of 3220 articles have principally traced. After excluding the irrelevant, ineligible, duplicated and very low-quality papers, only 10 studies were included in this review. Results: The highest prevalence rate of rotavirus in the Eastern Mediterranean Region countries was reported from Egypt by 76.9%1 followed by Bahrain by 44.8%2 then Jordan by 39.9%3 and it was less prevalent in Saudi Arabia and Sudan by 10% and 16% respectively4,5. Diarrhea, vomiting and fever were reported in high rates in most countries1-10, and in low rate in Saudi Arabia1. Dehydration was reported in Libya by 93.5%6, Bahrain by 95.3%2, Yemen by 59%10 and Egypt by 56%1. Conclusion: The prevalence of rotavirus in Eastern Mediterranean Region countries was ranged between 10% in Saudi Arabia to 76.9% in Egypt. Diarrhea, vomiting, and fever were more prevalent in many countries of the region while dehydration was mainly reported in Libya, Bahrain, and Egypt. [ABSTRACT FROM AUTHOR]