The rise in popularity of smartphones has seen a surge in the number of smartphone-specific software applications (apps) available. Among these apps, many are medical and healthcare related, of benefit to both the general public and healthcare staff. With this improved technology comes the ability to display full-colour images and videos, for which medical images could be utilised. We reviewed current clinical photography guidelines in relation to the publishing of medical images in smartphone apps. Of the 5 relevant guidelines, none discussed hand-held electronic media or smartphone app publishing. This creates confusion for clinicians as to how to interpret current guidelines for this purpose. Medical illustrators, clinicians and NHS Trusts need to be aware of the changes in technology and the ethical considerations of allowing medical images to be published within smartphones. We discuss the issues surrounding consent and provide practical tips for obtaining informed consent from patients to publish medical images in smartphone apps.