OBJECTIVE: This study aims to investigate the long-term effects of the COVID-19 pandemic on medical imaging case volumes. METHODS: This retrospective study analyzed data from the Integrated Radiology Information System-Picture Archive and Communication System (RIS-PACS), including monthly medical imaging case volumes at a public hospital, spanning from January 2019 to December 2022. The study collected data on medical imaging examinations, comparing the pre COVID-19 period, which acted as a control group, with the periods following COVID-19, which were designated as cohort groups. RESULTS: The total number of medical imaging procedures performed ( CONCLUSION: The COVID-19 pandemic initially led to a drop in the number of medical imaging procedures performed in 2020, with the most noticeable drop occurring during the early waves of the pandemic. However, this trend revealed a gradual recovery in the subsequent years, 2021 and 2022, as healthcare systems adapted, and pandemic-related restrictions were modified.