Aim: To assess the impact of the COVID-19 outbreak on trends in hospital admissions and number of diagnostic and therapeutic procedures in the largest tertiary vascular center in Hungary. Patients and Methods: A retrospective analysis was carried out. The first wave of the COVID-19 pandemic occurred approximately from March 15 until June 1 in Hungary. We have compared the same period of 2020 to 2019. Electronic medical records were reviewed for the clinical status of the patients and treatment-related information. Results: The total number of diagnostic angiographies and therapeutic interventions in 2020 (N 5 233) decreased significantly (P 5 0.046) compared to 2019 (N 5 373). The ratio of Fontaine stage I-II cases to Fontaine stage III-IV cases for both diagnostic angiographies and therapeutic interventions was significantly lower (OR, 2.11; 95% CI, 1.26-3.59; P 5 0.007 and OR, 3.22; 95% CI, 1.67-6.52; P < 0.001) in 2020 (0.36 and 0.27) than in 2019 (0.77 and 0.89). There was also a negative but not significant change in the number of supra-aortic (including internal carotid artery stenting) (P 5 0.128) and other vascular therapeutic interventions (superior vena caval stenting, hemodialysis access percutaneous transluminal angioplasty [PTA], visceral artery/vein PTA/stenting, embolization) (P 5 0.452) in 2020 (N 5 16 and N 5 21) compared to 2019 (N 5 39 and N 5 37). Conclusion: The first wave of the COVID-19 pandemic had a negative effect on the total number of endovascular procedures in the largest tertiary vascular center in Hungary.  Kulcsszavak: COVID-19 pandemic, interventional radiology, vascular procedures, peripheral artery disease, Fontaine stages