With the emergence of the COVID-19 pandemic, there was a noticeable decrease in respiratory infections. The aim of this paper is to show the incidence of invasive and non-invasive diseases caused by group A streptococcus in Croatia during the three years before the pandemic (2017-2019) and during the three years of the pandemic (2020-2022). The study is retrospective and includes all patients diagnosed with streptococcal angina, bacterial meningitis, scarlet fever, erysipelas, and sepsis, registered in the Register of Infectious Diseases of the Croatian Institute of Public Health,as well as all reported outbreaks. Before the pandemic, a significantly higher number of reported streptococcal angina, scarlet fever and erysipelas was observed compared to the three years of the pandemic (p = 0.0086, p = 0.0276, p = 0.0017). In the pre-pandemic era, seasonality was noticeable in streptococcal angina and scarlet fever. The highest number of angina patients was recorded between September and December (p = 0.0003), while the peak for scarlet fever was recorded between January and March (p = 0.0039). However, there was no significant difference in the number of reported patients for bacterial sepsis and meningitis caused by pyogenic streptococcus between the two observed periods. A total of 35 epidemics of streptococcal angina with 277 patients and six epidemics of scarlet fever with 51 patients were recorded, and most of the epidemics were in kindergartens (33 with 293 patients), then in families (six with 20 patients) and schools (two with 15 patients). Although a significantly lower number of streptococcal non-invasive infections was observed during the pandemic, with the relaxation of non-pharmacological measures to prevent the spread of COVID-19, there is a possibility of an increase in the number of patients. Therefore, it is necessary to closely monitor the movement of streptococci. Since epidemics of streptococcal angina and scarlet fever are most often recorded in kindergartens, good education of kindergarten employees, monitoring of diseases by the kindergarten health staff, quick communication with the competent epidemiologist and cooperation in the implementation of preventive anti-epidemic measures are important in stopping the spread of infection. Unlike other diseases that can be eradicated by vaccines, there are currently no available vaccines for diseases caused by pyogenic streptococcus, and they continue to represent a significant challenge for health professionals.