The goal of this project was to evaluate the overall use and effectiveness of a teleradiology system linking the Department of Radiology at the University of Arizona with a rural site 100 miles away. Workstations were installed at the referring and consulting sites with connections to all major imaging modalities, 83% of the time the correct type and number of images were sent to reach a diagnosis; 17% needed more images or had technical problems, Image quality was judged lo be adequate fur 85% of the cases. The consulting radiologists were very or somewhat confident in their decisions 88% of the time, Low confidence was directly related to judged image quality or number of images available. Consultation sessions lasted 7.73 min on average and 95% were judged to occur in a timely manner, 95% of the sessions were judged to be successful overall in terms of speed and diagnostic accuracy. The current teleradiology system provides a much needed service to a rural population of patients. Overall, both the consulting and referring radiologists are satisfied with the performance of the system and with their own diagnostic performance.