First lines: The global COVID-19 pandemic and the measures taken by governments around the world constitute a major rupture to the “business as usual”, and this includes the Western Balkans, too. The pandemic has been overshadowing other developments while also accelerating existing trends, and it will continue to do so. This analysis establishes the COVID-19 pandemic as a critical juncture, a crisis that can permanently shake up institutions and societies. There are considerable dangers beyond the impact of the pandemic on human lives, ranging from an economic crisis which could turn out to be worse than the one in 2008/9, to a heightened crisis of democracy and a geopolitical shift. None of these developments are inevitable and some of the consequences of the COVID-19 pandemic for the Western Balkans can be mitigated. By exploring nine critical fields, this analysis will highlight ways in which the pandemic and government responses pose particular challenges: 1. The Role of the State, 2. Democracy and State Capture, 3. Geopolitical Shifts,4. New Nationalisms, 5. Social Resilience, 6. Environmental Impact, 7. Migration and Health Care, 8. Health Care and Social Security and 9. Economic Implications. With regard to all of the critical fields, the study examines the impact and outlines possible risks and opportunities before identifying specific interventions that could prevent the worst consequences for the region.