Spirometry is a pulmonary function test normally performed in primary and secondary care as part of the diagnosis and assessment of patients with respiratory conditions, notably chronic obstructive pulmonary disease. Spirometry involves three main risks of transmitting the virus that causes coronavirus disease 2019 (COVID-19): aerosols, droplets and direct contact with contaminated surfaces. The COVID-19 pandemic therefore negatively affected spirometry testing, which had to be drastically reduced or interrupted. Services are being gradually restarted but concerns and challenges remain. This article describes the challenges posed by COVID-19 to spirometry testing and outlines the recommendations of professional organisations, including the Association for Respiratory Technology and Physiology and the Primary Care Respiratory Society, for restarting spirometry testing while ensuring patient and staff safety. The article also discusses innovative devices and new models of service delivery that could assist in ensuring that spirometry testing can be performed more safely.