Background/Objectives: In this study we aimed to assess the impact of Covid-19 pandemic period on the epidemiological trend of thyroid pathology in a university hospital in Romania. Methods: We performed a 6-years retrospective study (2017-2022) including all patients who underwent thyroid surgery, registered in the Pathology Department, Emergency County Hospital, Târgu-Mureș, Romania (n=971). Thyroid lesions were grouped into 3 major categories: (1) benign, non-tumoral, (2) benign, tumoral and (3) malignant, tumoral. To assess the impact of Covid-19 pandemic on the annual rate of thyroid surgeries and thyroid pathology, data were analyzed in comparison: before Covid-19 (2017-2019) versus Covid-19 and post-Covid-19 (2020-2022) period. Results: A significant decrease in the mean number of thyroid specimens per year was observed in the Covid-19 and post-Covid-19 period, compared to the previous period (131 versus 192 cases, p=0.0023). Thyroid benign lesions were the most frequent, but their prevalence was significantly lower during the pandemic period (50.8%), compared to the previous period (58.6%) (p=0.017). Benign tumors were rare, revealing similar occurrence rates in both periods. By contrast, the annual rate of malignant tumors increased significantly during Covid-19 and post-Covid-19 period (26.3% versus 35.4%, p=0.002), the most common histopathological type being papillary thyroid carcinoma. Conclusion: Along with Covid-19 pandemic (year 2020), due to reduced access to medical investigations, many thyroid cancers remained undiagnosed in our hospital. Consequently, this has led to an increased prevalence of malignant cases in the years that came after.