Background: Despite numerous prior interventions to reduce unnecessary visits to the emergency department (ED), overutilization and overreliance on EDs continue to negatively impact quality of care and cost. Objective: Motivated by finding solutions to ED overuse, we evaluated the effect of COVID19 on pediatric ED utilization, specifically focusing on patients with pulmonary diagnoses. Methods: A retrospective study was conducted to review visits to the pediatric ED at Phoenix Children’s Hospital. The baseline pre-COVID19 period ranged from 01/01/2016 to 03/14/2019. Post-COVID19 data were collected from 03/15/2020 to 07/31/2020. Study subjects included all patients between 0-18 years of age. Data was collected biweekly for the number of ED visits, admission to hospital from ED, presenting diagnosis and pulmonary consults. Results: The average number of biweekly ED visits decreased significantly from 3437 during baseline to 2061 post-COVID19, while the percent of hospital admissions increased from 0.14% to 0.18% (p< 0.01). A significant decrease was also observed in the biweekly average number of pulmonology consults (527 to 250), and the percent of pulmonology consults (0.15% to 0.11%), presenting diagnosis of asthma (130 to 59), tracheostomy (7 to 6), cystic fibrosis (7 to 5), cough/wheeze (66 to 41) and bronchiolitis/upper and lower respiratory tract infections (300 to 126). No changes were detected in chronic respiratory failure, respiratory distress or hypoxemia. Conclusion: Many factors including telehealth, improved infection control measures, social responsibility, and fear of getting sick may have played a role in the reduction in our ED visits during the COVID pandemic.