LEO/MEO systems are moving from a dream to a reality, their global reach is becoming apparent with the launch of the first LEO satellites. The global mobility offered by these systems is expected to have a profound effect on the way that organizations and individuals operate. Billions of dollars are invested in the research and development of LEO/MEO based communication systems, and larger amounts will be needed for their ongoing operation and use. Many global satellite based systems have been announced over the last decade, Ellipsat, Globalstar, ICO, Iridium, M?Star, Odyssey, Orbcomm, and Teledesic, are just a few of the many systems in deployment or under development. Being such a risky venture, limited experience exists in developing and managing large scale civilian satellite based mobile communication systems. Many interesting and challenging research issues are faced by the designers and operators of such systems. This paper presents the different approaches to the configuration of the various LEO and MEO based communication systems. It compares their advantages and disadvantages, and analyzes their economic viability. Based on the analysis, it is possible to identify the specific roles that each type will play in the global communication market. The paper presents and discusses some of the important research areas involved in their development, configuration, maintenance, operation and management. In particular, it introduces the problem of gateway placement in LEO/MEO systems and presents a mathematical formulation of the problem.