It accounts for hundreds more patients than the previous month and thousands more than a year ago.
A new report has revealed that 33,332 patients were listed as waiting for planned operations and procedures at The Shrewsbury and Telford Hospital NHS Trust (SaTH) in April, up from 32,674 in March.
In June 2020, the waiting list size at the trust which runs Royal Shrewsbury Hospital and Princess Royal Hospital in Telford stood at 23,087.
The report, which will be discussed by the trust's board on Thursday shows that in April 2021, a total of 3,687 patients on the waiting lists at SaTH had also been waiting for at least a year.
Staff have started tackling the record high backlogs that have come about as a result of the pandemic, with staff being redeployed to help battle coronavirus on the frontline.
In the report, the trust's chief operating officer, Nigel Lee, says April saw a continued fall in general acute and critical care regarding Covid activity.
Patients in hospital with coronavirus remained in single figures, although strict infection control measures remain in force.
‘Bioquell’ isolation pods have also been installed, providing more effective isolation and greater resilience for any future Covid surges, Mr Lee says.
He said: "In order to drive forward on recovery for patients requiring surgery, the trust has extended the contract for the Vanguard theatre and recovery unit for 12 months until March 2022.
"As availability of theatre staff remains a constraint, the benefit of this unit is that this includes theatre staff.
"Elective admitted activity plans still fall short of the level needed to reduce backlogs swiftly, and a set of further additional solutions is being reviewed at integrated care system (ICS) level for financial approval in early May for rapid implementation."
Bosses say patients with urgent and life-threatening conditions are prioritised for procedures and there have been additional weekend theatre sessions.
Mr Lee added: "We are working through the plans for the first half of 2021-22 to re-establish our capacity at pre-Covid levels, recognising that there will be a reduced capacity, as we need to apply appropriate safe practices."
Health bosses have previously said that the issue of treatment backlogs is being tackled by all health organisations in the county together, and that the solution could see some patients treated outside the area in a bid to get them seen more quickly.
Last month, the NHS announced it will spend £160 million on an initiative to find new ways of tackling the vast backlog of care.