Emergency surgery in the infectious diseases hospital is an urgent problem during the COVID-19 pandemic. Municipal Clinical Hospital No.15 named after O. M. Filatov has been providing emergency surgical care after conversion, from March 27, 2020 until now. The hospital’s medical staff has built up extensive experience: 194 surgical procedures were carried out in April, and 289 surgical procedures were carried out in May 2020. The paper reports the experience of emergency surgery at the stage of conversion to an infectious diseases hospital. Among all hospitalized patients, 482 (5.29%) people had acute surgical pathology requiring emergency surgery. Among patients who underwent urgent surgery, 472 (98%) people had the caused by COVID-19 community-acquired pneumonia of various degrees of severity. The paper discusses some features of acute surgical pathology and complications identified in patients with COVID-19. The surgical care features in the hospital after conversion are proper epidemiological regime implementation, minimization of the number of staff in the operating room, possible minimization of the number and reduction of the duration of surgical procedures. The most important challenge during the COVID-19 pandemic is medical staff safety. © 2020 Pirogov Russian National Research Medical University. All rights reserved.