Head and neck oncological surgery involves the resection of the tumour and reconstruction of the defect, commonly with free or pedicled flaps. Monitoring the viability of flaps, particularly free flaps, in the postoperative period is a vital aspect of management. Colour, capillary refill after local blanching, temperature, turgidity and Doppler ultrasound examination are used to monitor viability. If there is doubt, advice from a more senior surgeon is generally required. Images, video and text can be transmitted through the Internet at relatively little expense. Digital imaging allows easy storage and retrieval of data, transmission of information through the Internet, and good images if high quality cameras (of about a million pixels resolution) are used. The greater the density of pixels, the greater the resolution.1 Telemedicine, which is remote medical care resulting from telecommunications and information technology,2 can mean still digital images or real time interaction with video links. Digital photographic systems have gained in popularity in recent years, and have been applied in a number of clinical disciplines, including distant assessment of trauma,3 remote management of wounds,4 and in dermatological5–7 and plastic surgical practice.8 There are few reports on digital photography in maxillofacial surgery. If high quality images of flaps can be obtained with good colour reproducibility, and then transferred through the Internet to a distant site while maintaining high quality, it is possible that digital technology may be used as an adjunct to free flap monitoring by obtaining a remote assessment of viability. It would not replace the usual methods of monitoring.