The frontline of hospital in providing health services related to Covid-19 outbreak is the Emergency Room (ER), so that it comes as a high-risk place for Covid-19 transmission among patients and patients as well as patients and health workers in the medical context. To prevent the transmission, several changes should be done in ER during Covid-19 pandemic. Besides, this research aimed at analyzing the changes made to ER as an effort to prevent and control Covid-19 infection which could be utilized as a recommendation for the ER towards other hospitals during this epidemic disease. The method used in this article was a literature review by researching the design through Google Scholar, Mendeley, and PubMed. The keywords included emergency department, hospital, changes, guidelines, preparedness, and Covid-19. The criteria of selected articles were published in 2020 using full English text, and the type of research was descriptive qualitative research. In addition, the total of the articles were 5 used articles which should match the research criteria related to the topic of the research. Based on the results of the literature reviews from the experts, the changes made to ER during the Covid-19 pandemic were divided into 3 parts such as preparation, pre-triage and during triage. Likewise, the made changes during the preparation consisted of organizational structure and leadership, human resource management, infrastructure, and logistics. Likewise, the changes made during pre-triage were online clinics and patient screening. At last, the change made during triage was in line with the patients’ triage flow.