Teledermatology has been the focus of much interest in recent years. It holds great potential for revolutionizing the delivery of dermatology services, providing equitable service to remote areas and allowing primary care physicians to refer patients todermatology centres of excellence at a distance. Teledermatology can be applied in one of two ways: it may be conducted in real-time, utilizing videoconferencing equipment, or by "store and forward" methods, when transmitted digital images or photographs are submitted with a clinical history. "Store and forward" teledermatology systems are easy to set up, cheaper and more convenient for the health care provider, but lack the immediacy of patient contact with the dermatologist, and involve a delay in obtaining the diagnosis and advice on management. Studies to date have generally found that real-time dermatology is likely to allow greater clinical information to be obtained from the patient. It must be recognized that teledermatology is potentially a useful communication tool for selected patients in primary care but is unlikely to solve waiting list problems or replace the need for local dermatology services. Before its routine application as a service tool, its reliability, accuracy and cost-effectiveness need to be verified by rigorous evaluation. It is increasingly likely that teledermatology will prove to be a significant tool in the provision of dermatology services in the future.