More than half of patients are waiting longer than the 26-week target for orthopaedic treatment.
The report found 101,014 people waiting for orthopaedic treatment in Wales, a 56% increase compared to March 2020.
Adrian Crompton, the auditor general, said waiting times for orthopaedic treatment had been a challenge for the NHS for "many years", with the pandemic making them "significantly worse"."It is positive to see that there is a clear commitment to improve orthopaedic services, but urgent action is needed to secure short-term improvements in waiting times," he said.
The report has recommended the Welsh government prepare a clear delivery plan to improve wait times, improve efficiency and productivity within the service and improve communication and support for those waiting.
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