Objectives To assess how otological surgery resumed following the UK’s first wave of the COVID-19 pandemic and what challenges clinicians faced when operating. Design A multi-centre prospective audit of elective and emergency otological surgery Participants 1130 cases from 79 hospital sites across the UK (excluding Northern Ireland). Data was collected over three, 4-week audit periods from 15th June to 6th September 2020. Main outcome measures Which operations were being performed in England, Scotland and Wales? What was the use of personal protective equipment (PPE)? Were there a greater number of complications? What was the level of trainee participation? Did any patients or patients contract COVID-19? Results 85.8% of operations took place in England. 69.1% of operations were middle ear procedures and 58% of patients were adults. 83.2% were Caucasian and 93.9% of patients had minimal co-morbidities (ASA 1 or 2). 91.1% were for tested SARS-CoV-2 pre-operatively, none of whom tested positive. 70.4% isolated for 7-14 days pre-operatively. 28.2% of surgeons wore full personal protective equipment (PPE), compared with 66.6% of anaesthetists and 68.2% of scrub staff. Trainees were present in 80.3% of cases. Complications were reported in 4% of cases; surgical site infection was the most common. No patients or staff contracted SARS-CoV-2 during the audit. Conclusions Restarting otology surgery after the first wave of the SARS-CoV-2 pandemic was performed safely across the UK, with no increase in complication rates or SARS-CoV-2 transmission. However, there were challenges to operating with PPE and trainees have been affected by reduced exposure to surgical cases.