Aim: Bystander cardiopulmonary resuscitation (CPR) combined with public-access defibrillation has been shown to enhance overall survival for out-of-hospital cardiac arrest. This is one of top reasons of mortality across the globe. The COVID-19 global epidemic has modeled numerous problems for emergency medical services, along with reference of compression-only resuscitation also guidelines for comprehensive protective equipment. These suggestions and advice have created shortcomings and protracted fast response. On the other hand, the risk variables that determine the results of OHCA while the pandemic is ongoing are not well established. The main aim of our research remained to explore medical features in addition results of OHCA individuals in Pakistan both before and after the COVID-19 epidemic. Methods: The electronic medical records and paper records kept by EMS were utilized to compile the data for this single-center, retrospective observational analysis. The number of emergency hospital returns based on varying qualities in Pakistan institute of Medical Sciences (PIMS), Islamabad Hospitalized patients during and prior to the COVID-19 pandemic in Pakistan were collected. Patients with OHCA who went to the emergency department at PIMS, Islamabad before the COVID-19 pandemic (April 2019 to March 2020) were identified. Results: Here were a total of 145 patients who participated in this study (80 males, or 58.2% of the total; mean [SD] age, 64.7 years); 64 among those individuals contributed in our current research during the COVID-19 era, and 75 among those individuals contributed in our current research before COVID-19 period. Bystander witnessing and method of chest compression was always the two general baseline features that were found to be substantially different between the two groups (p-values of less than 0.002 and less than 0.002, accordingly). During the COVID-19 era, the ED ROSC was substantially lower than it had been before the COVID-19 period (25.68 percent vs 45.04 percent; adjusted odds ratio of 0.22; p-value less than 0.002) Survival to admission remained suggestively inferior throughout COVID-19 phase compared to the previous time period (26.01 percent vs 41.78 percent, accustomed odds ratio of 0.27, p-value of 0.006). On the other hand, there was no important statistically substantial difference in the 28-day survival rates (4.5% throughout COVID-19 era also 11.54% earlier COVID-19 period). Conclusion: Patients who had cardiac arrest outside of a hospital in Pakistan had a much lower chance of surviving long enough to be admitted during the COVID-19 epidemic that occurred there. In addition, the two groups' witness reactions and methods of cardiopulmonary resuscitation couldn't have been more different from one another. Keywords: Bystander cardiopulmonary resuscitation, OHCA, Covid-19 pandemic, EMS.