Background.　Over　the　past　two　decades,　scarlet　fever　has　resurged　in　some　countries　or　areas.　Nationwide　nonpharmaceutical　interventions　changed　the　patterns　of　other　infectious　diseases,　but　its　effects　on　the　spread　of　scarlet　fever　were　rarely　studied.　This　study　aimed　to　evaluate　the　changes　in　scarlet　fever　incidence　in　Zhejiang　Province,　China,　before　and　during　the　COVID-19　pandemic　periods　and　to　provide　references　for　scarlet　fever　prevention　and　control.　Methods.　Scarlet　fever　surveillance　data　in　Zhejiang,　China　(2004-2022),　were　analyzed　in　three　stages.　Two-sample　z　test,　ANOVA,　and　Tukey＇s　test　were　used　to　compare　and　analyze　the　characteristics　of　disease　spread　at　different　stages.　The　ARIMA　model　was　used　to　predict　the　overall　trend.　The　data　were　obtained　from　the　National　Infectious　Disease　Reporting　Information　System.　Results.　A　total　of　28,652　cases　of　scarlet　fever　were　reported　across　Zhejiang　Province　during　the　study　period,　with　the　lowest　average　monthly　incidences　in　2020　(0.111/100,000).　The　predominant　areas　affected　were　the　northern　and　central　regions　of　Zhejiang,　and　all　regions　of　Zhejiang　experienced　a　decrease　in　incidence　in　2020.　The　steepest　decline　in　incidence　in　2020　was　found　in　children　aged　0-4　years　(67.3%　decrease　from　23.8/100,000　to　7.8/100,000).　The　seasonal　pattern　changed,　with　peak　occurrences　in　April　to　June　and　November　to　January　during　2004-2019　and　2021　and　a　peak　in　January　in　2020.　The　median　duration　from　diagnosis　to　confirmation　was　highest　before　COVID-19　(4　days);　however,　it　decreased　to　1　day　in　2020-2022,　matching　the　other　two　medians.　Conclusions.　In　2020,　Zhejiang　experienced　an　unprecedented　decrease　in　scarlet　fever,　with　the　lowest　incidence　in　nearly　18　years,　but　it　rebounded　in　2021　and　2022.　The　seasonal　epidemiologic　characteristics　of　scarlet　fever　also　changed　with　the　COVID-19　outbreaks.　This　suggested　that　nationwide　nonpharmaceutical　interventions　greatly　depressed　the　spread　of　scarlet　fever.　With　the　relaxation　of　non-pharmaceutical　intervention　restrictions,　scarlet　fever　may　reappear.　Government　policymakers　should　prioritize　the　control　of　future　scarlet　fever　outbreaks　for　public　health.