The current COVID-19 pandemic is most challenging for healthcare systems all over the world. The most diff cult part for the surgeons is to change their usual focus from trying to benefit their individual patients to focusing on the benefit of the community. This shift from patient-centred ethics to public health ethics has. occurred in many ways throughout the world. Many patients had their surgeries postponed due to the pandemic. Surgeons had to cancel their patients non urgent operations, even though the patients needed surgery and patients accepted the risks of having surgery with unknown COVID-19 status. Th e risk of perioperative morbidity and mortality increased when operating on patients with either asymptomatic or symptomatic COVID-19. During the postoperative period, if patient develops fever or pulmonary complications will lead to diagnostic challenge which will complicate the recovery of patients from elective surgery. Th ere is a possibility of performing elective operative interventions on patients with asymptomatic or mild form of COVID-19 which will lead to contamination of operative room and surgical equipment’s, with increased risk of transmission of the COVID-19 infection to surgical team and other healthcare providers in hospitals. Most of the surgeons explain operations to patients and a shared decision is made giving high priority to patient choices. As scarcities of materials increase, surgeons frequently unable to respect patient’s choice as much as they have traditionally done. During COVID-19 pandemic surgeons and health care organizations responded appropriately and cancelled many elective surgical procedures. Many cancer screening procedures were stopped, and priority was given to urgent cancer treatment. Endoscopy and proctological procedures were performed highly selectively. Preservation of emergency surgical response takes top priority. Critical services such as trauma, thoracic surgery, vascular surgery, and neurosurgery were continued to be operated when rosters for the COVID-19 duty was prepared. Surgeons prioritized operations that are both surgically necessary and time sensitive to perform. Patient needing an emergency operation was not cancelled. Most tricky one is to decide which operations to proceed with and which can wait is this unusual circumstance. All invasive Cardiovascular and cancer surgeries were cancelled if not urgent when there are high risk factors (age > 60 y, HTN, DM, smoking history, CAD, CHF, COPD). Efforts were made to temporarily postpone urgent cases using nonoperative means and discharge patients home at increasing rates.