Real-time audiovisual consultation (telemedicine) has been proven feasible and may be a promising alternative to interfacility transfer. We sought to describe caregiver perceptions of the decision to transfer his or her child to a pediatric emergency department and the potential use of telemedicine as an alternative to transfer. The aim of this study was to review current literature concerning telemedicine in pediatric medicine including its clinical applications and challenges related to its implementation. Telemedicine has a potential role in pediatric emergency medicine for real-time decision making to improve quality of care for children. Telemedicine may be a technological tool that's improving the health of youngsters round the world. This report chronicles the utilization of telemedicine by pediatricians and pediatric medical and surgical specialists to deliver inpatient and outpatient care, educate physicians and patients, and conduct medical research. Although certain challenges have constrained more widespread implementation, telemedicine’s current use bears testimony to its effectiveness and potential. Telemedicine’s widespread adoption are going to be influenced by the implementation of key provisions of the Patient Protection and Affordable Care Act, technological advances, and growing patient demand for virtual visits. Pediatric emergency telemedicine consultations are shown to supply support to community emergency departments treating critically ill pediatric patients.