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Background: Confirmed coronavirus disease 2019 (COVID-19) patients sometimes require emergency surgery, but protecting healthcare workers and other patients from infection is a high priority. This report describes two cases where surgeries were performed in a hospital without a negative-pressure operating room. Case: Two patients diagnosed with COVID-19 required emergency surgery in a negative-pressure isolation room. Two operating rooms were designated an operating room and an anteroom, and the central air conditioning system was turned off. The disinfection exhaust fan of the operating room was used to create a negative-pressure environment (–1.0 Pa). Conclusions: Performing surgery on COVID-19 patients remains challenging in hospitals not specialized for infection. It is necessary to share experiences between hospitals, and changing the pressure inside the operating room from positive to negative pressure with a simple maneuver is a good option for protection.