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Background The COVID-19 pandemic caused changes in daily life and disrupted hospital performance and the provision of medical services, especially in the organ transplant departments. Objective This study aims to compare the frequency of organ donation and transplantation before and after the COVID-19 outbreak in the transplant centers of northern Iran. Methods This cross-sectional study was conducted on 75 donors with brain death from 2018 to 2021 in Rasht. Demographic data, underlying diseases, history of smoking and drug use, causes of brain death, type of donated organ, number of donated organs per patient, type of transplanted organ, and the location of transplantation (in or out of the province) were recorded. Then, these factors were compared between two time periods: Before the pandemic (from July 2018 to February 2020) and during the pandemic (from February 2020 to August 2021). The recorded data was analyzed in SPSS software, version 21. The significance level was set at 0.05. Results The mean age of donors during the pandemic was significantly higher than that of patients before the pandemic (P<0.001). The most common cause of brain death in donors before the pandemic was trauma; after the pandemic, cerebrovascular causes were more common (P=0.01). The frequency of organ donation and the mean number of donated organs per donor during the pandemic were significantly lower than before the pandemic (P<0.001). Conclusion The COVID-19 pandemic has significant impact on the process of organ donation and transplantation in northern Iran. [ABSTRACT FROM AUTHOR]