The Defence Medical Services (DMS) Telemedicine Unit won awards for innovation from the British Computer Society in 1998 and the current version of the software went live on 7^th April 2003. We present a review of the referrals made to the Unit from April 2003 to March 2005. Over this two-year period the Unit received 110 referrals from areas such as Falkland Islands, Bosnia, Ghana, HMS Ocean and Belize. We consider the referral patterns; reporting times; ease of use; and clinical consequences of the system.