Telemedicine provides the opportunity to bring medical expertise to the bedside, even if the medical expert is not physically near the patient. Internet technology has facilitated telemedicine allowing for voice, video and other data to be exchanged between remote locations. To date, applications of telemedicine to anesthesia (Teleanesthesia) have been limited. Previous work by Cone et al., (Anesth Analg 2006;1463-7) demonstrated the ability to direct an anesthetic in a remote location using satellite communication. In this report, we describe the use of telemedicine to support two cases of elective living related pediatric liver transplants performed at the Narayana Hrudayalaya Institute of Medical Sciences in Bangalore, India with preoperative and intraoperative consultation provided by physicians at the Children's Hospital of Philadelphia.