This World Health Organization publication provides a comprehensive analysis of the implications of the COVID-19 pandemic on patient safety. It highlights the safety gaps exposed across health systems globally and discusses both the negative impacts, such as disruptions in healthcare services and increased risks of harm, and positive developments during the pandemic. The work emphasizes the link between patient safety and health equity, and how long-standing structural inequities were highlighted by the pandemic. Intended for healthcare professionals, policymakers, and researchers, it aims to inform strategies to improve patient safety and health system resilience.