Research into the use of videoconferencing for clinical purposes, in particular psychotherapy, is gradually expanding. A number of case studies and case series have suggested that videoconferencing can be clinically effective and acceptable to patients. Nevertheless, there is a lack of methodologically rigorous studies with adequate sample sizes from which we can draw any generalisable conclusions and a dearth of randomised controlled studies. Many of the preliminary projects in this area have been feasibility studies with minimal focus on outcome and even less on process issues in psychotherapy. Few studies have explored the cost-effectiveness of this compared with other modes of therapy delivery. This paper aims to review the work that has been done to date within this field, and to explore the issues which need to be addressed if videoconferencing is to be taken seriously in the future as a legitimate and reliable means of delivering psychotherapy services.