Abstract
This systematic review and meta-analysis was a study that enquired into the prevalence and epidemiology of depression in university students in Pakistan, between 2000 and 2025. Depression is a significant global mental illness with high prevalence in young adulthood. University students are the most susceptible to this risk because of the factors related to it, i.e., academic stress, financial hardships, social pressure, and cultural stigma of mental illness. Although the concerns have been on the increase, the prevalence rates of depression have been widely varied among Pakistani students, with some studies reporting as low as 2.5% to as high as 85%, primarily because of the sampling techniques, assessment instruments, and geographical settings. The present review is based on the findings of 35 studies involving over 11,000 students and suggests that the prevalence rate is approximately 51% in a pooled form, meaning that about 50% of university students in Pakistan are subjected to depressive symptoms. The high level of heterogeneity of the selected studies highlights the acute necessity of the formulation of a standard-based diagnostic criteria and culturally competent mental health assessment instruments. Moreover, systemic challenges, such as the shortage of trained mental health professionals and the general unawareness of the disorder, are continuing to affect the diagnosis and treatment of the disorder at an early stage. According to the results, the necessity of a multi-faceted approach toward mental health, including the establishment of counseling facilities in universities, the development of stress management training, and the federal stigma-reduction campaign, is pressing. The most significant elements of enhancing the well-being of students and the mental health landscape of Pakistan as a whole are early intervention and empowering mental health infrastructure.