Disaster events have always been a fact of life. Success or failure of a disaster response is often determined by timely access to communication and reliable information. The rapid progress and future course in telecommunications indicate that lack of communications need no longer be the paralyzing factor in a disaster scenario. This is especially important for medical response where time is of essence to save lives. This article explores various telecommunications tools that can enhance medical response in a disaster and includes those associated with telemedicine (providing medical care from a distance through telecommunications). Disaster telemedicine systems need not be special or sophisticated-the challenge is to match the right systems with a given disaster plan or scenario. A brief history of telemedicine use for disaster relief and humanitarian assistance is presented together with a discussion of advantages, disadvantages, and near-future potential of telecommunication systems to gain a better perspective of which tools might best fit disaster medicine needs today and into the new millennium.