AbstractThis study aimed to investigate the advantages, disadvantages, working methods, and support needs of physicians practicing teleradiology from home in Japan, as well as to explore challenges related to the COVID-19 pandemic. We conducted semi-structured interviews with 15 physicians (12 radiologists and 3 neurosurgeons) engaged in teleradiology services. Participants were recruited through purposive sampling to ensure diversity in age, gender, and experience. Data were analyzed using inductive thematic analysis following Braun and Clarke’s six-step approach. Five main themes were generated: (1) the ability to work from home according to one’s lifestyle, allowing for better work-life balance; (2) reduced quality and efficiency of reading work, due to limited patient information and lack of immediate consultation; (3) self-management and reliance on available resources, including literature searches and networking with colleagues; (4) need for comfortable infrastructure facilities, such as high-quality monitors and stable internet connections; and (5) provision of resources to resolve questions and concerns, including platforms for peer discussions. Interestingly, no specific themes related to the COVID-19 pandemic were identified, suggesting that the challenges of teleradiology were not uniquely affected by the pandemic. While home-based teleradiology offers lifestyle flexibility, it presents challenges in maintaining work quality and efficiency. Physicians employ self-management strategies and rely on available resources to mitigate these challenges. The findings highlight the need for improved infrastructure and support systems to enhance the practice of home-based teleradiology in Japan. This study contributes to the growing body of literature on remote healthcare delivery and may inform policy decisions and best practices in diagnostic radiology both in Japan and internationally.