A mobile ear-screening service was established in an Aboriginal community in central Queensland. Telemedicine allowed ear nose and throat (ENT) specialists at the tertiary children's hospital in Brisbane to assess children at a distance using pre-recorded information comprising video-otoscopic images and the results of tympanometry and audiometry. During the first three years, 1053 children were registered with the service. A total of 2111 screening assessments were carried out at 21 schools in the region. The average screening rate achieved in the community was 85%. More than half of all assessments resulted in a referral to the ENT specialist (for online assessment) or local doctor (for treatment). Twenty specialist ENT online clinics were conducted during which 415 patients were reviewed. Over half of all online review cases (55%) resulted in appointments at the next ENT outreach clinic for further review and/or surgery. The community-based screening service led by local Indigenous health workers, and linked to a tertiary children's hospital by telemedicine, was an effective method for routine screening of children at risk of hearing impairment.