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Telemedicine in surgery sometimes referred to as "Telesurgery" has been successfully demonstrated in developed countries.This study is local experience from Pakistan.Materials and Methods: This descriptive study was conducted at surgical unit II holy family hospital Rawalpindi (tertiary care hospital) and Tehsil head quarter Pindi gheb (remote center) from t0 1.7.05 to 1.12.05 The objectives of the study were to evaluate the role of telemedicine in pre operative assessment of patients at remote location without the need to travel to tertiary care center at a distant location,post operative care.in comparison with patients seeking surgical treatment in excisting conventional manner.Results: The average number of visits for pre operative assessment at tertiary care hospital without telemedicine was 11 and with the use of telemedicine this number reduced t0 1.Time lapse between first appearance at remote site and consultant advice was reduced t0 4 days from 15 days.Post operative stay at holy family hospital came down t0 4 days from 15 days.Follow up visits were reduced to 1 as compared to 4 visits.There were no unnecessary referrals with use of telemedicine as compared to 4 cases which could have been managed at remote center without the need of surgical intervention.No complications were observed in the patients evaluated through telemedicine.Conclusion: Telemedicine applications used in the proper technical and clinical algorithms can be very effective in supporting remote health care deliverv efforts.The advantages of such applications include increased cost effectiveness by limiting travel,expending services to patients and increased patient quality assurance.