Objectives To determine the perceived threats, psychological stress and economic concerns among practicing otolaryngologists in low and middle income countries facing the furry of COVID-19 pandemic, exposing the soft underbelly of healthcare systems in resource limited economies. Design A cross sectional anonymous, self-reported questionnaire-based study was carried out among otolaryngologists in India over a period of 3 weeks during the countrywide lock-down. Setting An online platform was used to host a questionnaire, publicized using various social media platforms. Participants A total of 178 participants landed on the page, 73 were excluded at the first question itself, in all 105 otolaryngologists, who were allowed to proceed, completed the questionnaire. Main Outcomes and Measures There are clear indications of psychological stress among the practicing otolaryngologists. Main reasons being anxiety about risk of infection from patients for self, staff members and family, and economic impact of the increased protective measures needed in view of pandemic. Results Out of the 105 Otolaryngologists who completed the survey, 57 (52.8%) were from private sector. Significantly (p=0.001) higher number of private doctors (66.7%) feared about escalated cost of running out-patient clinics compared to government doctors (33.3%). Majority (80.8%) were against routine surgeries during pandemic and difference between private and government doctors was not significant (p=0.765). Increased stress during this pandemic was perceived by 73.1%. Conclusions It can be safely concluded based on this survey based study that to alleviate fears of otolaryngologists in low middle income countries; a comprehensive policy intervention is the need of the hour.