Between January and August 1993, 59 medical teleconsultations were conducted successfully between the video teleconference center at Tripler Army Medical Center on Oahu and the video teleconference center on Kwajalein Atoll in the Republic of the Marshall Islands. This pioneer effort in the Pacific connected 2 archipeligoes separated by more than 2,200 nautical miles. Diagnostic and therapeutic decisions were made in the specialties of orthopedics, dermatology, radiology, urology, pediatrics, ophthalmology and physical therapy. Geographic isolation no longer means limited medical specialty care.