Background: The prevalence of major depressive disorder (MDD) in Chinese older adults in epidemiological surveys have been inconsistent. We thus conducted a systematic review and meta-analysis of the pooled prevalence of MDD in older adults in China. Methods: Two investigators independently conducted a systematic literature search in English (PubMed, EMBASE, PsycINFO and Cochrane Library) and Chinese (CNKI, Sinomed and Wan Fang) databases. Studies reporting the prevalence of MDD in older adults in China using diagnostic instruments were identified and analyzed using the Comprehensive Meta-Analysis program. Results: A total of 28 studies with 76,432 subjects were included. The mean age ranged from 62.1 to 74.1 years. The point prevalence of MDD in older adults was 2.7% (95% CI: 2.1%–3.4%), 12-month prevalence was 2.3% (95% CI: 0.6%–8.5%), and lifetime prevalence was 2.8% (95% CI: 1.8%–4.4%). Subgroup analyses revealed significant differences in the prevalence of MDD across regions. Conclusion: The prevalence of MDD in older adults varied across different regions in China. Further epidemiological studies and service planning should take into account such differences.