Purpose of Study: Access to specialized child health services is critical to population health. In the province of British Columbia (population 4.6M, land area 365,000 mi2), BC Children’s Hospital (BCCH) is the sole tertiary care center for children. Consequently, geographically remote families must travel great distances to visit with a pediatric specialist; this travel often results in lost time and considerable expense for these families. In an effort to improve access to healthcare for remote/rural children and their families, BCCH began offering Telehealth as an alternative to in person appointments for select new patient and follow-up consultations. Methods Used: A comprehensive literature search was performed in order to define current state for surgical Telehealth in other jurisdictions—especially with respect to pediatric surgery—which helped inform technology and patient selection and the early clinical experience. Satisfaction questionnaires from patients, clinical support staff, and health care providers were analyzed to determine the effectiveness of Telehealth consultations. Surgical wound photographs were collected and assessed in an attempt to measure inter-observer reliability, and validate a protocol for post-operative wound assessment by Telehealth. Summary of Results: The analysis of 23 patient questionnaires in this pilot study showed high patient satisfaction with the surgical Telehealth service; 100% of patients (and their families) indicated that they would use this service again. If Telehealth had not been offered, patients would have had to travel an average of 5.4 hours longer to attend their appointment. The child’s perception of their consultation compared to that of an in-person examination. The technique used for wound assessment by Telehealth offered an equivalent outcome to an in-person assessment. Conclusions: Advances in technology have made it possible to improve access to healthcare by way of tools like Telehealth; technology can effectively connect patients to practitioners, despite great distances between the two. High levels of patient and provider satisfaction in this study indicate the potential of Telehealth to improve patient outcomes and experience when applied to children’s surgical care.