Advances in technology affect many aspects of daily life, and health care is no exception. A report by the Institute of Medicine (2001), Crossing the Quality Chasm: A New Health System for the 21st Century, has identified health information technology as one of the critical forces that could significantly improve clinical decision-making, patient safety, and overall quality of health care in the United States. The President's New Freedom Commission on Mental Health 2003 report Achieving the Promise: Transforming Mental Health Care in America has recommended telecommunications technologies as one of the most promising means of improving access to specialty mental health care. Many new technologies now contribute to increasing access to mental health services and to improving the quality of that care. Telepsychiatry is one of these new technologies that uses interactive videoteleconferencing, or televideo, to allow a psychiatrist and patient in different locations to interact in real time for the provision of care that usually is delivered in person. Child and adolescent telepsychiatry could substantially change psychiatric practice by bringing services not only to underserved communities but also to naturalistic settings like schools and day care, and potentially into patients' homes. Here, we provide an overview of the development, applications, and future of child and adolescent telepsychiatry.