Objectives: To assess trends in otolaryngology-head and neck surgery (ORL-HNS) referrals among pediatric patients, and to address common urgent causes of ORL-HNS referrals in this population. Additionally, to give recommendations regarding these causes, and assessing the impacts of coronavirus desease-19 on such referrals. Methods:A retrospective descriptive study were the data was extracted from the referral system of the Saudi Ministry of Health (Ehalati), from 2019-2020. Pediatric patients from all hospitals across Saudi Arabia with problems related to ORL-HNS who have been referred urgently to other hospitals were included.Results: A total of 1318 urgent ORL-HNS referrals were collected. The average age of the sample was 6.5 years, with the unavailability of specialty being the major cause for referrals. Foreign bodies, recurrent epistaxis, and tracheostomy were also common clinical causes. The average time for accepting referrals was 21 hours.