Virtual reality (VR) can be considered as the leading edge of a general evolution of present communication interfaces involving the television, computer, and telephone. The main characteristic of this evolution is the full immersion of the human sensorimotor channels into a vivid and global communication experience. Because telemedicine principally focuses on transmitting medical information, VR has the potential to enhance this function. Particularly, VR can be used in telemedicine as an advanced communication interface, which enables a more intuitive mode of interacting with information, and as a flexible environment that enhances the feeling of physical presence during the interaction. In this article, the state of the art in VR-based telemedicine applications is described. This technology is now used in remote or augmented surgery as well as surgical training, which are critically dependent on eye-hand coordination. Recently, however, different researchers have tried to use virtual environments in medical visualization and for assessment and rehabilitation in neuropsychology. This article also discusses technological, ergonomical, and human factor issues, and specific guidelines are presented for expanding the use of VR in telemedicine.