question: STUDY DESIGN Cross sectional survey. OBJECTIVE To investigate the impact of the COVID-19 pandemic on the clinical practices of spine surgeon within the Asia Pacific region. SUMMARY OF BACKGROUND DATA COVID-19 pandemic had changed spine surgeons clinical practices and their concerns towards personal and family risk of infection. METHODS This cross-sectional survey was carried out from 4 May 2020 to 4 June 2020. The questionnaire was administered using REDCAP (Vanderbilt, Nashville, TN, USA). The online questionnaire includes four section. First section- surgeon's demographics, background, type of clinical practice, and status of pandemic in their country. Second- volume and the type of spine surgery practice prior to the COVID pandemic. Third- changes of clinical practice during the pandemic and lastly- regarding their concern on COVID transmission. RESULTS Total of 222 respondents from 19 countries completed the questionnaire. During the pandemic, 92.3% of the respondents felt their clinical practice was affected. 58.5% respondents reported reduced outpatient clinic hours and 74.6% respondents reported reduced operation theatre hours due to the enforcement by the hospital administration. The mean reduction of clinic volume for all countries was 48.1%. There was a significant reduction in the number of surgeries performed in Japan, Malaysia, India, Philippines, and South Korea. This was due to reduced patient load. More than 60% of respondents were worried being infected by COVID-19 virus and more than 68% were worried to transmit to their family members. CONCLUSION COVID-19 pandemic had significantly affected the clinical and surgical practice of spine surgeons in the Asia Pacific region. Clinics were closed or the practice hours reduced. Similarly, surgical theatres were closed, reduced, or limited to semi-emergency and emergency surgeries. Spine surgeons were moderately concerned of contracting COVID-19 during their clinical practice but were extremely concerned to transmit this disease to their family members. LEVEL OF EVIDENCE 4.