A territory-wide retrospective observational study was conducted in Hong Kong between January 23 to April 22, 2020 to demonstrate changes in pediatric seizure-related accident and emergency department (A&E) visits during the COVID-19 pandemic. Parallel periods from 2015 to 2019 were used as control. All-cause A&E attendances in all paediatric age groups decreased significantly during the study period. Seizure-related attendances decreased across all pediatric age-groups in 2020 (RR 0.379, 95% CI 0.245–0.588), with a disproportionately large decrease in the 0–6 years age group (RR 0.303, 95% CI 0.174–0.526) compared with the 7–18 years age group (RR 0.534, 95% CI 0.393–0.719). Decrease in RTI-related A&E attendances was also more drastic in the 0–6 age group. The two time trends are congruent in the 0–6 years but not the 7–18 years age group. Such a trend is suggestive of the usefulness of infection control measures in seizure prevention, especially amongst young children.