The COVID-19 pandemic changed the lives of very nearly every person in the world. For the music therapy profession and those populations that can benefit from its application, the ramifications are no less palpable, though they have been changing on a day-today basis. During the initial phase of the pandemic, the expressive therapy team, including the music therapists at Primary Children’s Hospital in Salt Lake City, was directed to work remotely using virtual platforms to facilitate services. Several studies conducted both prior to the pandemic and since its arrival in the United States demonstrate the delivery of expressive therapies via remote, web-based platforms. However, there is a general lack of literature on the subject. This article brings forward 3 case examples in order to illustrate the methods of achieving goals and objectives in distanced music therapy: a 5-year-old girl needing a heart transplant, an 11-year-old girl requiring tri-weekly hemodialysis for end-stage renal disease, and 2 brothers whose sister died of rhabdomyosarcoma and who was treated at Primary Children’s Hospital. These case stories offer perspective on both the challenges and positive responses that occurred throughout the process, with a focus on the adaptation to virtual music therapy services during the COVID-19 pandemic.