Introduction Since the COVID-19 pandemic started in Europe early 2020, day-to-day practice in care homes has changed considerably. Common elements of music therapy - singing, physical contact, proximity - have become questionable. This study explores the impact of the COVID-19 pandemic on music therapy provision and continuation in Dutch care homes. Method In December 2020 and January 2021 Dutch music therapists (n = 49) working in elderly care filled out an online survey on their experiences with the COVID-19 pandemic during the first and second wave. Results Twenty different measures were deployed to adapt and continue music therapy throughout the pandemic. Music therapists were required to deploy social distancing, disinfect hands and instruments, and wear a face mask. Residents from different units were frequently unable to participate in music therapy together. Prevalent adaptations were to provide sessions in a common room (79.6%), in smaller groups (67.4%), for more (individual) residents than usual (65.3%) and to use pre-recorded playlists (65.3%). Music therapists experienced low stress and moderate to high hope, despite the substantial impact of the pandemic on professional and personal musical activities. Discussion Music therapy provision in care homes has repeatedly been subject to restrictions throughout the pandemic. By the end of the second wave, music therapy had been resumed in care homes, albeit with a range of preventive measures implemented in daily work routines. The pandemic shed light on adaptability of music therapy as a treatment and demonstrates that employer support is essential to enable music therapy provision.