Abstract Introduction In the developed world, doctors use the Internet to support the delivery of health care. Their usage patterns are explained by Rogers’ Diffusion of Innovations. There is no knowledge of Internet usage by doctors in the developing world. Methods In July 2006, 2600 survey forms were posted in the first national survey of South African (SA) General Practitioners’ (GPs) use of the Internet. A sample of non-responders was followed up. The aim was to determine SA GPs’ Internet usage patterns, to compare them to world usage, and to examine them in the light of Diffusion of Innovations. Results A 10% usable response rate was a major weakness, but similar surveys are unlikely to be more representative. 89% of SA GPs have Internet access, home usage is high, and overall usage patterns are equivalent to the usage patterns of international studies. Discussion In spite of the overall technological under-development in South Africa, as predicted by Diffusion of Innovations, SA GPs have adopted the technology, and use it for health care in much the same way as their international counterparts. Further studies on some of the details will be valuable. Conclusion The indications are that SA GPs will reap the benefits of the Internet as it continues to evolve, and translate these into improved health care delivery in South Africa.