Background: During flight, fast jet pilots frequently move their heads into extreme positions while withstanding large amounts of stress on their cervical spines. These factors are thought to contribute to episodes of neck pain. Methods: We conducted a systematic review and meta-analysis of previous neck pain prevalence data in fast jet pilots to determine an overall pooled prevalence. Subgroup analyses were performed according to when pilots complained about their neck pain, whether these same pilots sought treatment, and if they lost time from flying. Four research databases were searched. Studies were eligible for inclusion if they were written in English, involved a group of fast jet pilots who were actively flying high performance aircraft, and reported quantitative prevalence data about neck pain in these pilots. These eligibility criteria were independently applied by two reviewers and risk of bias was evaluated. MetaXL software was used to conduct the meta-analysis. Results: In total, 8003 fast jet pilots across 18 eligible studies were included in the review. The overall pooled prevalence of neck pain in fast jet pilots was 51%. It was found that 39% of subjects lost time from flying, while only 32% sought medical treatment. Discussion: Neck pain in fast jet pilots adversely affects operational capabilities of defense forces. The prevalence of neck pain varies according to the definitions or thresholds of complaints used across the literature. Further research is required to standardize the definition of neck pain.