Teleotolaryngology is becoming a reality as a result of improvements in technology and telecommunications. This prospective, clinical trial was designed to demonstrate the utility of three telemedicine systems in an otolaryngology practice. Optel is a desktop system used in the office. Picasso is a mobile system used from various locations throughout the hospital. The Georgia Statewide Telemedicine Program (GSTP) is a large, sophisticated system used from a fixed site within a rural hospital. Patients with a wide variety of ear, nose, and throat problems were presented to consultants at two medical teaching centers in Georgia. Fifty-four consults were completed over a 24-month period. In addition, three teleconsultations demonstrated enhanced capabilities for continuing medical education (CME) and health care networks. Nine different specialty fields were accessed by the otolaryngologist. Five consults were completed via the Optel system; 13 via the Picasso system; and 36 via GSTP. Overall, teleotolaryngology provided quality audio and visual communication between the physicians that significantly improved diagnostic capabilities and treatment options for the patient.