Telemedicine was introduced in Canadian pediatric cardiology practice in 1987 in the Maritime provinces with real-time echocardiography transmissions. This early experience was adopted progressively by other provinces, and, with technological progress, many different applications are now available. Telemedicine has now become an essential tool in providing access to one of the 15 pediatric cardiology centers for the entire Canadian population from coast to coast. This includes teleconsultations and surgical discussions. Additionally, a teleeducation program links all 15 centers for professional education. Indeed, 16 years after its introduction, telemedicine has become as essential component in the delivery of pediatric cardiology. We will likely see further development in this field consistent with technological advances and patient demand as well as expanded networks and newer applications.