The diagnosis of clinically significant prostate cancer is often challenging. The 4K® score test may assist in evaluating the risk of significant malignancy and avoid biopsies in non-significant disease. The COVID-19 pandemic caused a remarkable disruption in managing patients with suspected prostate cancer. The aim of this study is to evaluate the effect of the COVID-19 pandemic on 4K ®score test results by comparing tests performed in Israel between April to July 2020 to a control group of the same period in 2019. During the COVID-19 era there were few quarantine periods in which citizens were allowed to leave their homes for specific reasons only (eg, medical consultations). Meanwhile, medical clinics were operating in limited schedule with intention to treat emergent cases only. We assumed that focusing on coping with the pandemic and its implications will decrease prostate MRI tests and prostate biopsies and as a result, there will an increase in the 4K score blood tests as well as a change in the pre-biopsies prostate risk stratification.