Background <p>The COVID-19 pandemic significantly disrupted healthcare systems worldwide, prompting substantial changes in medical services, including elective surgical procedures. This study examines the impact of the pandemic on residency training in a tertiary pediatric otolaryngology department in Israel.</p> Objective <p>To assess the effects of the COVID-19 pandemic on surgical volume and the training experiences of pediatric otolaryngology residents, with a focus on changes in surgical case types and frequencies.</p> Methods <p>We conducted a retrospective chart review of fifteen residents who completed pediatric otolaryngology rotations at Schneider Children’s Medical Center between 2019 and 2021. The study period was divided into three years: pre-pandemic (2019), first pandemic year (2020), and second pandemic year (2021). Continuous variables were analyzed using one-way analysis of variance (ANOVA), and categorical variables were compared using the Chi-square or Fisher’s exact test when appropriate.</p> Results <p>A total of 1,992 surgical procedures were performed during the study period: 614 (31%) in 2019, 874 (43%) in 2020, and 504 (26%) in 2021. The proportion of urgent procedures increased significantly across the study period, rising from 10.3% in 2019 to 11.9% in 2020 and 20.6% in 2021 (<i>p</i> &lt; 0.001). Foreign body–related surgeries increased to 7% of all procedures in 2021 compared with 4% in both 2019 and 2020 (<i>p</i> = 0.03), whereas infection-related procedures remained relatively stable. The mean number of surgeries performed per resident declined from 64.1 in 2019 and 72.8 in 2020 to 40.0 in 2021, although this reduction did not reach statistical significance (<i>p</i> = 0.204).</p> Conclusion <p>The COVID-19 pandemic led to considerable fluctuations in surgical volume and case types, significantly affecting pediatric otolaryngology training. These findings highlight the need for adaptable training strategies to maintain educational quality during healthcare crises.</p>