ENT emergencies are heterogeneous and include infections, inflammatory and traumatic conditions. We observed what appeared to be a dramatic alteration in emergency presentations to our unit during the early phase of 1st COVID-19 Lockdown in 2020. Objective- This study compares pre COVID-19 presentations with 1st Lockdown presentations and examines the overall numbers; conditions encountered and draw conclusions which may influence future planning for ENT services. Setting-Records for emergency ENT presentations to a regional centre were examined for two comparable 61-day time periods. Design and Participants-Presentations for April and May 2019 (pre COVID-19) were compared to April and May 2020 (1st Lockdown). Records were compared with regards to overall numbers, demography, diagnosis and treatment. Admissions for COVID-19 related airway interventions and admissions/attendances for elective complications were excluded. Results and conclusion-In the pre COVID-19 group, 649 emergency presentations were recorded: 401 infection related cases, 90 epistaxis, and 158 non-infectious/traumatic cases. In the 1st Lockdown group, 254 emergency presentations were recorded: 121 infection related cases, 56 epistaxis and 77 non-infectious/ traumatic cases. Overall, there was a 61% reduction in emergency presentations during the 1st Lockdown. Infectious cases reduced by 70%, epistaxis reduced by 38% and non-infectious cases fell by 51%. All of these differences were statistically significant (p value <0.05). The infectious category showed the greatest reduction in presentations and within this category the greatest change was observed in Laryngeal infections (95%), facial cellulitis (84%) and Tonsil infections (73%).