Advances in telecommunications and computer software have led to the development of radiology image transfer systems. Radiologists may now report radiographs at a site distant from that of the examination, in some cases almost instantaneously. Computed tomography, magnetic resonance imaging, and ultrasonography may also be supervised from afar. Developments over the past few decades are reviewed, allowing an understanding of the systems currently available. These include systems that transmit static images and real time video systems that enable interactive supervision from a radiologist at a distant site. The implications for the practice of radiology are discussed and the main areas of development over the next few years explored.