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Telemedicine uses video communication to evaluate patients at an originating site by a distant physician. Telestroke was developed to apply telemedicine for the delivery of stroke expertise to hospitals with limited or no available stroke capability. This chapter reviews the most commonly used models of telestroke networks. It discusses the evidence for telestroke, including its value in managing patients with ischemic stroke who are candidates for intravenous alteplase and endovascular thrombectomy, as well as patients with intracerebral hemorrhage. Economic, legislative, and legal issues of treating patients within a telestroke network are also reviewed. Future advances in telemedicine will continue to deliver expert care in a way that brings comprehensive care to patient’s doorstep.