Apollo Hospitals, Chennai, India started telemedical service in1999. More than 78,000 consultations in 25 different disciplies were done so far and one tenth of them were telepsychiatric consultations. After an initial face to face consultation and treatment, they were followed up, using real time video based tele consultation periodically. Patients spread over in and around Indian sub -continent, from a distance of 200 kilo meters to 7500 kilo meters were seen. An equal number of male and female patients, mostly middle aged with the diagnosis of anxiety, depressive and psychotic disorders. Clinical, equipment and administrative standards were followed. Satisfied mental health consumers came for regular repeated tele- consultation follow-up.