The use of radiotelemetry for continuous electrocardiographic monitoring of patients outside of special care units, although common practice in many community hospitals, has not been adequately studied. Two-hundred five consecutive patients placed on telemetry over a 3-month period were prospectively studied to determine the benefits of radiotelemetry. Fourteen episodes of significant arrhythmias in 12 patients who required specific intervention were detected over 608 patient-days of monitoring. Significant arrhythmias occurred only in patients with known or suspected coronary artery disease or in those with previously documented arrhythmias. Radiotelemetry in a community hospital, when available at a moderate daily fee and observed by trained personnel, appears to be a cost-effective and safe method of monitoring patients at moderate risk for life-threatening arrhythmias. Although the overall cost of the system appears justifiable because of better utilization of special care unit beds and the seriousness of the arrhythmias detected, there is no evidence showing an increase in either in-hospital or postdischarge survival in monitored patients. Any potential benefit is probably restricted to patients with definite or suspected coronary artery disease or previously documented arrhythmias. Telemetry in a community hospital can provide a valuable alternative to special care unit monitoring in selected cases, but its value in the assessment of syncope and palpitations in the absence of high clinical suspicion of arrhythmia is limited.