Care of pediatric patients with special healthcare needs is often complicated by lack of availability of necessary subspecialists. The Department of Pediatrics at The Medical College of Georgia contracted with Children's Medical Services of Georgia to provide subspecialty care and consultation to patients in remote areas using telemedicine. Data on 331 telemedicine consultations during the period December 12, 1995 to May 31, 1997 were collected. Caregivers were interviewed regarding their perceptions of care given via telemedicine and faculty physicians were querried regarding their perceptions of telemedicine. Costs of travel were estimated. Costs were also calculated for patients to receive telemedicine services. Most telemedicine consults (36%) involved the pediatric allergy/immunology subspecialty. Others included pulmonology (29%), neurology (18%), and genetics(16%). Most patients (66%) waited 15 minutes or less to be seen over the telemedicine system, compared to only 20% who waited 15 minutes or less in on-site, non-telemedicine clinics. For patients paying for travel “out-of-pocket”, cost of travel is reduced by almost 25% when patients are seen via telemedicine as compared to round trip travel costs to the tertiary care center. Overall, clients were very satisfied with services received. Physician faculty were positive but more conservative. As the project progressed, their attitudes became more positive. It is concluded that for recipient families, telemedicine reduces costs and is well-received. In addition, faculty physicians generally feel telemedicine is an acceptable means of delivering specific pediatric subspecialty consultation services.