Telecommunications from telephone and radio to two-way audio, video, facsimile (fax), and digital imaging via satellite transmission have been used in responses to disasters. Current and rapidly emerging communications technology offers the prospect of enormously expanded and more efficient application in predisaster, acute, and postdisaster rehabilitation activities. A survey of present and potential roles for telemedicine in disaster medicine will be presented with particular focus on initial on-going medical needs assessment, prevention programs, and emergency assistance for provision of emergency care of victims, care for other survivors, and public health and sanitation services. Attention will also focus on telemedicine in education and training, disaster response exercises, development of comprehensive plans, and research. Finally, the essential relationship between the routine utilization of telemedicine in predisaster health care and effective employment in disaster situations will be discussed.