Objective: As the coronavirus disease 2019 (COVID-19) pandemic continues, it is believed that COVID-19 may have affected the transportation time of 119 emergency medical services (EMS). However, there are only a few studies to support this claim. The current study was undertaken to investigate the altered pre-hospital transportation time according to the severity of the patient after the COVID-19 period. Methods: This is a retrospective observational study conducted on patients aged 15 or older who visited three emergency medical centers from January 1, 2019, to December 31, 2020, using the 119 EMS. The primary outcome was total pre-hospital transportation time; secondary outcomes include activation time, response time, on-scene, and transportation time. Results: Before COVID-19, the total pre-hospital transportation times for patients admitted to the intensive care unit and patients with out-of-cardiac arrest were 26.78±9.91 minutes and 27.92±8.38 minutes, respectively. Post-COVID-19, the time increased to 35.31±16.30 minutes and 32.46±14.69 minutes, respectively (P<0.001). Furthermore, the total prehospital transportation time before and after COVID-19 differed in the critical patient group with Korean Triage and Acuity Scale 1 and 2 (26.58±10.12 minutes vs. 33.93±15.78 minutes). In addition, an increase in the total pre-hospital transportation time was observed after COVID-19 in the emergency and non-emergency patient groups. An increased time interval was also determined for the activation time, response time, on-scene arrival, and transportation time for all patient groups after the COVID-19 pandemic (P<0.001). Conclusion: COVID-19 has resulted in delays throughout the pre-hospital transportation time, greatly impacting critical patients.