Background COVID-19 pandemic has impacted several aspects of health care services worldwide. Our aim was to study its influence on the case volume, success rate and complication rate of ERCP. Method All patients who underwent ERCP one-year before and after applying COVID-19 safety measures at Qena university hospital were included. Data were collected from the patients' records, analyzed and compared. Result A total of 250 patients were subjected to ERCP between April 1, 2019 and March 31, 2021, mean age 52±18. There was 5% increase in case volume after applying COVID-19 safety measures than before (128 vs 122) and the total procedure time was significantly shorter (42 versus 46 minutes, p=0.04). The overall success rate and complication rate showed no significant difference. Procedure success significantly corelated to cannulation attempts and total procedure time in both groups, and serum bilirubin and cannulation time in patients before COVID-19, and ALP in patients after. ERCP related complications significantly correlated with cannulation attempts in both groups, and ALP, INR, cannulation time and total procedure time in patients before COVID-19, and platelets count and amylase after. Two patients were confirmed COVID-19 cases at the time of ERCP, therapeutic targets were achieved in both with smooth post-ERCP recovery. Three out of 9 ERCP team members have caught mild to moderate COVID-19 infection and recovered after receiving proper management. Conclusion Our result showed no negative impact of using COVID-19 safety measures and precautions on the case-volume, indications, overall outcome or complication rate of ERCP.