During the first year of COVID-19 pandemic, while there have been rapid developments in diagnosis and treatment of the disease; drug interactions and side effects have created a problem especially in high risk patients with chronic diseases and multiple drug use. In contrast to the routine vaccine production process, SARS-CoV-2 vaccines have been developed in a short period of time by many pharmaceutical companies, and community vaccination has started in many countries. However, this process is restricted by mutation and problems in production and distribution. The fact that the pathophysiology of the disease has not been fully elucidated has brought the prolonged COVID-19 syndrome definition to our clinical practice. Positive improvements and negative aspects that we have encountered so far in the first year of this new pandemic reminded us the great film by Sergio Leone: ?The Good, The Bad and The Ugly?. So, we decided to cover these aspects under the same headings. Gaining an overview of the many developments, problems and solution ideas we encountered and witnessed during the pandemic year will make the management of the process easier.