Background: The COVID-19 pandemic led to a reduction in elective surgeries by assessing the urgency of surgeries and surgical rooms being converted into additional ICUs. This study aimed to analyze the selection of surgery types, length of stay, and the needs of post-elective surgery ICU before and during the COVID-19 pandemic at Dr. Soetomo General Hospital Surabaya. Methods: The study was an observational analytic study, with a retrospective cohort design. Subjects were adult patients who require elective surgeries at Dr. Soetomo General Hospital in March 2019 - February 2021. Data on the type of surgery, length of stay, and needs of ICU after elective surgery were obtained from medical records. Statistical analysis was done using comparative tests according to the type of research data. Results: A total of 8971 patients were included in the study. There was significant differences in the distribution of the types of surgeries (p=<0.001) and ICU needs (p=0.017) before and during the pandemic. The total surgeries were reduced by 41.4%. The needs for ICU increased from 1% before the pandemic to 1.6% during the pandemic. There was no significant difference in the distribution of length of stay before and during the pandemic (p=0.978). Conclusion: There were differences in the number of types of operations and the needs of post-elective surgery ICU before and during the COVID-19 pandemic. But there was no difference in the length of stay of patients after elective surgery before and during the COVID-19 pandemic.