The COVID-19 pandemic has led to a significant shift in the practice of almost all medical fields. Surgical specialities were particularly hard hit as these services had to give way to the more urgent management of COVID-19 patients both in-ward and in intensive care units. In otorhinolaryngology (ORL) practice, an additional issue to be dealt with was a relatively higher risk of being exposed to viral droplets from aerosol-generating procedures and examination of oral and nasal cavities of patients. This article describes our experience in managing ORL services at a government tertiary referral hospital, Hospital Raja Permaisuri Bainun, Ipoh, during the current COVID-19 outbreak since the year 2020. Two novel strategies were introduced namely the outsourcing of radiotherapy services for cancer patients and an innovative design in endoscopic examination of patients.