question: BACKGROUND: Various public health interventions have been implemented against the COVID‐19 pandemic. We investigated herein changes in pediatric emergency healthcare utilization during the current pandemic. METHODS: Based on data on outpatient healthcare visits to one pediatric emergency department in Tokyo, Japan, the descriptive, cross‐sectional study compared the number of emergency department visits between 2020 and the previous three years. Data were extracted from the electronic triage reporting system. The primary outcome was the number of emergency department visits. The characteristics of patients by age group were also investigated. RESULTS: A 40.6% reduction in pediatric emergency healthcare utilization was observed during the study period, with the greatest decrease occurring in the number of visits for fever. However, while the number of patients with a complaint with an exogenous cause decreased, the proportion of these patients increased. Although social activities in the greater community have now almost normalized, and only a slight increase in the number of patients with fever has been reported, the number of emergency department visits remains lower than in previous years as of this writing. CONCLUSIONS: Public health interventions led to a reduction in emergency department visits, thereby allowing time to redistribute health care resources.