AimsCOVID-19 is an ongoing global pandemic that poses potential increase in the risk of post-operative complications. Early guidelines placed an embargo on minimal access surgery, aiming to minimise risk to patients and the surgical team through aerolisation of the virus. We aimed to assess the practice of minimal access surgery during the peak of the pandemic and associated surgical outcomes.MethodsAn email link to an online questionnaire was distributed to a variety of surgical specialties via the Royal College of Surgeons COVID group and ALSGBI members. Data collection was carried out over a 4-month period. Data assessed included screening methods, case volume, surgical approach and patient outcomes.ResultsA total of 118 responses from a variety of surgical specialties were collected over 59 units, ranging in grade from Consultant to SHO/Core Trainee.The volume of minimal access procedures decreased during the pandemic from 94.9% of units to 39.0% (P < 0.001), with a greater percentage opting for an open approach (54.2% vs 39.0%, P < 0.001).Combining screening methods was a favoured approach, and it was frequently used alongside a designated ‘Clean’ theatre.A small proportion of patients suffered from post-operative COVID-19 complications (15.3%), but COVID-19 mortality was low.ConclusionsWhilst the risk of COVID-19 infection was not completely abolished perioperatively throughout the pandemic, it appears to be minimised by use of adequate screening with designated clean areas. It would therefore support guidelines advocating continued use of minimal access surgery during peaks of COVID-19 if prudent peri-operative measures are taken.