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The aim of this paper is to explore the legal tools the Spanish constitutional system holds to face a health crisis as serious in its scope and consequences and as lengthy in time such as that of the COVID-19 pandemic. First, we explain the state of alarm provided for in Organic Law 4/1981, 1st June, regulating the states of alarm, exception and siege; then, the provisions included in Organic Law 3/1986, on extraordinary measures in the field of public health. Both regulations have been the legal basis to adopt different state and regional health measures during this almost year and a half of the pandemic. The last July 14, the Spanish Constitutional Court made public the appeal of unconstitutionality lodged by more than fifty deputies of the Vox parliamentary group against Royal Decree 463/2020, of March 14 (articles 7, 9, 10 and 11), by which the state of alarm was declared for the management of the health crisis caused by COVID-19 and several regulations that modified that Decree or extended it. This judgement suggests a different legal response -the declaration of the state of exception- to deal with the health crisis and be critically analyzed in third place., (Copyright © 2022 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)