The provision of quality pharmacy services to rural and remote communities is influenced by the National Strategy for the Quality Use of Medicines. The implementation of this strategy is challenged by the shortage of pharmacists in rural areas. Australia compares unfavourably with both the UK and US in this regard. The Fourth Community Pharmacy Agreement between the Commonwealth of Australia and the Pharmacy Guild commits the parties to 13 key objectives and makes provision for funding initiatives for professional pharmacy programs. Two of these programs are medication reviews and e-health initiatives. Telepharmacy, as an enabling technology, represents a unique and innovative way to deliver quality pharmacy services to rural areas. Telepharmacy operations are in place in other countries. In the US, two principal models are in Washington State and North Dakota, although other states such as Texas, Nebraska and Alaska also have telepharmacy models in place. Studies in Australia have had mixed results and have not been as successful. However, there are some promising models that have been employed in telemedicine, including for the delivery of physiotherapy and other allied health services. It is of key importance to involve pharmacists in telepharmacy services and a key initiative to be studied soon in far north Queensland will involve home medication reviews being conducted via telepharmacy.