Introduction: During the COVID-19 pandemic, pediatric visits due to acute lower respiratory infections (ALRIs) decreased, but most reports are from hospitalized patients. There is little information on this phenomenon in outpatients, who are the majority in IRABs. We evaluated the impact of the COVID-19 pandemic on ALRIs related outpatient visits in the City of Buenos Aires. Methods: Observational study including all outpatient visits of children under 2 years of age to the public health system of the City of Buenos Aires, between Jan 01, 2018 and Dec 31, 2022. We estimated the total number visits and the ALRIs-related visits, and their distribution throughout the study period. Results: A total of 704,426 visits were registered, 7.38% of them due to ALRIs. ALRIs-related visits decreased from the implementation of a national lockdown (2020) and increased again as the restriction measures decreased, particularly the return to full school attendance (2021). In general, the proportion of ALRIs-related vists was significantly higher in the cold months than in the warm ones (9.8% vs. 5.5%; OR: 1.76, 95%CI: 1.73-1.79; p<0.001). This difference was observed before (2018, 2019) and after the pandemic (2022), but not in 2020-2021. The peak of ALRIs-related visits occurred in the cold months in pre-pandemic years (2018-2019), did not appear in 2020, reappeared delayed in 2021 and recovered seasonality in 2022. Conclusion: Outpatient ALRIs-related visits decreased significantly in the city of Buenos Aires during the COVID-19 pandemic and currently seem to have recovered their magnitude and seasonality.