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We determine how pediatric emergency department (ED) visits changed during the COVID-19 pandemic in a large sample of U.S. EDs. Using retrospective data from January-June 2020, compared to a similar 2019 period, we calculated weekly 2020-2019 ratios of Non-COVID-19 ED visits for adults and children (age 18years or less) by age range. Outcomes were pediatric ED visit rates before and after the onset of pandemic, by age, disposition, and diagnosis. We included data from 2,213,828 visits to 144 EDs and 4 urgent care centers in 18U.S. states,