Open Access (OA) dissemination has been gaining a lot of momentum over the last decade, thanks to the implementation of several OA policies by funders and institutions, as well as the development of several new platforms that facilitate the publication of OA content at low or no cost. Studies have shown that nearly half of the contemporary scientific literature could be available online for free. However, few studies have compared the use of OA literature across countries. This study aims to provide a global picture of OA adoption by countries, using two indicators: publications in OA and references made to articles in OA. We find that, on average, low-income countries are publishing and citing OA at the highest rate, while upper middle-income countries and higher-income countries publish and cite OA articles at below world-average rates. These results highlight national differences in OA uptake and suggest that more OA initiatives at the institutional, national, and international levels are needed to support wider adoption of open scholarship.