Abstract. Using data envelopment analysis (DEA), the current study aims to assess the healthcare systems efficiency of in 26 European countries with Covid-19. This study developed DEA models to assist decision-makers in European countries via seven different scenarios to address the inefficiency of health systems following Covid-19. The input variables of the adopted DEA models include the number of conducted tests, medical doctors, nurses, hospital beds, and GDP. At the same time, the output variables include the number of affected, recovered, and deaths cases. Various output scenarios were considered and analyzed. Out of 26 European Countries, twelve were found efficient in all the assumed output scenarios. Moreover, we found four countries efficient in four scenarios out of the seven. Besides, another five countries have an efficiency level between 50%-90% in all the assumed output scenarios. Lastly, five countries have total efficiency levels at most 35% in each scenario. According to the developed DEA models, the countries under study can be divided into four main levels: efficient, efficient with some inefficiency, inefficient, and severely inefficient. Generally, more than 50% of the European countries have moderate to severe problems in their healthcare systems. Those countries have major issues in facing virus transmission. In general, healthcare-system-adapted DEA allows assessing the relative efficiency for countries. It is easy to perform, and it can provide helpful information which assists policymakers in continuous improvement.