Proper design of rooms for telemedicine store-and-forward and realtime interactive consultations is critical. The challenge is to incorporate communication technology into medical practice to facilitate efficient communication and effective patient care. If this is done properly, the technology becomes unnoticeable to those involved in the telemedicine interaction. This article describes some of the steps that can be taken in a telemedicine room design to achieve this goal. Room location, treatments, background, lighting, power and telecommunications aspects are reviewed. Although every room design will have its own unique challenges, adhering to these basic principles will provide an excellent foundation to begin with.