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Abstract Objectives Data from radiological departments provide important information on overall quantities of medical care provided. With this study we used a comprehensive analysis of radiological examinations as a surrogate marker to quantify the effect of the different COVID-19 waves on medical care provided. Methods Radiological examination volumes during the different waves of infection were compared among each other as well as to time-matched control periods from pre-pandemic years using a locally weighted scatterplot smoothing as well as negative binominal regression models. Results A total of 1,321,119 radiological examinations were analyzed. Examination volumes were reduced by about 10% over the whole study period (IRR = 0.90; 95% CI 0.89–0.92), with a focus on acute medical care (0.84; 0.83–0.85) and outpatients (0.93: 0.90–0.97). When compared to wave 1, examination volumes were about 17% higher during wave 2 (1.17; 1.10–1.25), and 33% higher in wave 3 of the pandemic (1.33; 1.24–1.42). Conclusions This study shows the severe effect of COVID-19 pandemic and related shutdown measures on overall provided medical care as measured by radiological examinations. When compared, the decrease of medical care was more pronounced in the earlier waves of the pandemic.