Background and aim of the work: The outbreak of the novel coronavirus (or SARS-CoV 2) has struck the healthcare system worldwide. Within few weeks hospitals had to reorganize their internal logistics and structure covering any level of care, from the Emergency Room to medical Departments. Methods: Due to the state of medical emergency, the Gynecology and Obstetrics Unit of the University Hospital in Udine developed new protocols for the usual standard of care, ensuring a safe environment for both healthcare providers and patients. Results: By a continuous update of scientific evidence, the Department was able to increase capacity as well as maintain flexibility when an unexpected high number of admissions was required. 40 COVID-19 positive patients were admitted to our Department between March and December 2020, none of them had complications and no case of cross infection between patients and medical staff were registered. Conclusion: We aimed to share our experience, which provided a notable lesson about what to expect and how to prepare a high-risk pregnancy referral center in response to a pandemic. (www.actabiomedica.it)