Kristalina Georgieva said 2023 will be "tougher" than last year as the US, EU and China see their economies slow.
In October the IMF cut its global economic growth outlook for 2023."We expect one third of the world economy to be in recession," Ms Georgieva said on the CBS news programme Face the Nation.
"Even countries that are not in recession, it would feel like recession for hundreds of millions of people," she added.
While our baseline avoids a global recession over the next year, odds of one are uncomfortably high. Europe, however, will not escape recession and the US is teetering on the verge," she said.
The IMF cut its outlook for global economic growth in 2023 in October, due to the war in Ukraine as well as higher interest rates as central banks around the world attempt to rein in rising prices.
Since then China has scrapped its zero-Covid policy and started to reopen its economy, even as coronavirus infections have spread rapidly in the country.
Ms Georgieva warned that China, the world's second largest economy, would face a difficult start to 2023.