Nepal is a landlocked country with China in the northern side and India in the east, west and south. Nepal shares a 1,414 kilometres (879 mi) border with China's autonomous region of Tibet, in the Himalayas. China is Nepal's second-largest trading partner. Nepal has an 1,800-km open border with India in the east, west and south. Nepal lies in South Asia, one of the least developed and most densely populated world regions, that performs poorly in education as well as health care and sanitation metrics, and is therefore considered one of the highest risk areas for the pandemic, and also one of the least prepared.

According to The Kathmandu Post, before the pandemic, hospitals in Nepal had few ICU beds (just three in Teku Hospital) which were almost always occupied, with people in critical condition usually having to wait for the beds to become empty. It reported doctors as saying that it would be next to impossible to admit new patients to ICU as soon as they need them.Teku Hospital, the only one designated for handling infectious disease, had built an isolation ward during the avian influenza outbreak a decade ago, but had never brought it into use, as it did not have experts to evaluate or maintain the required standards.

As news of a new infectious disease in China broke, concerns were raised in Nepal over the high potential risk, the need to implement preventive measures and a severe lack of necessary medical equipment and infrastructure. According to Baburam Marasini, former director of Epidemiology and Disease Control Division, Nepal does not have any double cab ambulances to transport highly infectious patients safely, isolation wards in hospitals, or biosafety level-3 or better laboratories needed to test for highly infectious diseases.

The global COVID-19 coronavirus pandemic was confirmed to have spread to Nepal when its first case was confirmed in Kathmandu on 24 January 2020. The patient showed mild symptoms and had been discharged a week earlier with instructions to self-quarantine at home; he was subsequently confirmed to have completely recovered. Between January and March, Nepal took steps to prevent a widespread outbreak of the disease, while preparing for it by procuring essential supplies, equipment and medicine, upgrading health infrastructure, training medical personnel, and spreading public awareness. The second case was confirmed on 23 March 2020 in Kathmandu. As of 14 April 2020, 14 additional cases have been confirmed, one each in Rautahat and Kanchanpur, two in Baglung, three each in Parsa and Kathmandu, and four in Kailali district. Eleven of the cases involved people who had recently returned from abroad, and three of them were Indian nationals residing in Nepal; the first case of local transmission was confirmed on 4 April in a 34-year-old woman from Kailali. A country-wide lockdown came into effect on 24 March, and is scheduled to end on 27 April.

Nepal established health-desks at the international airport as well as on border checkpoints with India, starting in mid-January. Land borders with India as well as China were later completely sealed off, and all international flights suspended. All academic examinations were cancelled, and schools and colleges were closed. QAuarantine centres and temporary hospitals are being setup across the country. Laboratory facilities are being upgraded and expanded. Hospitals have been setting up ICU units and isolation beds. The SAARC countries have pledged to cooperate in controlling the disease in the region. India, the United States and Germany have increased their support to Nepali health sector.

Nepal cancelled its international promotional activities related to Visit Nepal Year 2020. Its economy is expected to be severely affected by the pandemic due its impact on foreign employment, tourism, manufacturing, construction and trade.