COVID-19 affected different countries differently. The WHO/ PNIPH, WHO/EMRO, and the Palestinian MoH, with assistance from the PCBS carried out a serological survey in the occupied Palestinian Territories in order to estimate the actual number of COVID-19 infection by the end of December 2020. A sample stratified by Region, district, and by type (urban, rural, and refugee camp), and accounting for gender, was taken from Gaza and the West Bank. The results show that 39% of the oPt (38% of the West Bank and 40% of Gaza), had been infected with COVID-19 by the end of December, almost 10 times the number that was detected by targeted Rt-PCR testing.