INTRODUCTION: The coronavirus disease 2019 pandemic prompted significant alterations in emergency department accessibility owing to government-imposed health policies. These changes influenced the frequency of return emergency department visits among older adults, but empirical investigations on this topic remain scarce. This study aimed to examine trends in emergency department return visits among older adults in South Korea during the coronavirus disease 2019 pandemic. METHODS: Older adults (n = 11,034) who returned to the emergency department within 30 days of their last visits from 2019 to 2021 were included. Data on age, sex, acuity score, health insurance type, medical transportation type, emergency department boarding time, chief complaints, final diagnosis, coronavirus disease 2019 infection status, and discharge plan were analyzed. RESULTS: The total number of return visits was highest in 2019 (before the pandemic) and lowest in 2021 (the second year of the pandemic). Although the overall proportion of return visitors declined annually, a consistent subgroup of older adults with lower acuity symptoms continued to present to the emergency department throughout the study period. Concurrently, as the total number of return visits decreased, the proportion of those eligible for ward admission increased. Emergency department boarding times decreased markedly in 2020, with a modest increase observed in 2021. Final diagnoses remained largely consistent over the 3-year period. DISCUSSION: Despite fears related to the pandemic, older adults continued to return to the emergency department likely owing to restricted access to local clinics and the suspension of home visit nursing services. To enhance health care delivery in future pandemics, the development of accessible, user-friendly online health care platforms for older adults is recommended.