The COVID-19 pandemic has affected the conduct of clinical trials in an unparalleled manner due to multiple levels of restrictions imposed to control the spread of SARS-CoV2. These restrictions have presented major challenges for clinicians, sponsors, contract research organizations and patients participating in ongoing clinical trials and have necessitated alternative solutions to ensure study and patient care continuity. In this review, we assessed the impact of the pandemic on key metrics of the commencement and continuation of clinical trials in the Asia-Pacific region and the efforts made to mitigate these challenges. Overall, newly initiated studies in 2020, outside of those directly related to COVID-19, were reduced. Access to sites and recruitment were also impacted significantly although recovery has begun in the latter half of 2020. Clinical trials consist of complex workflows across study procedures and site-patient engagements. Based on clinician and industry surveys, the impact of COVID-19 may drive an increase in interest and adoption of virtual, digital technologies and tools to help alleviate the numerous challenges for clinical trial stakeholders. We discuss these new approaches and debate their readiness and appropriateness for widespread use. With ongoing acceleration of the pandemic and the maturation of technology, we expect increasing near-term adoption of virtual and digital methodologies in clinical trials. As a silver lining of the pandemic, these approaches may make studies more patient centric, improve clinical trial efficiency and enhance the experience and care of the patients enrolled on trials.