El Salvador responded rapidly and effectively to the emergence of the SARS-CoV-2 virus in the country. In line with WHO advice, El Salvador stepped up preparedness of its health system in mid-January and announced a national emergency on 30 January, the same day that WHO declared COVID-19 a public health emergency of international concern. El Salvador’s strong response has been built on equipping hospitals, community level care and training health workers, plus preparing for vaccine rollout, which commenced 17 February 2021.