Telemedicine at Asahikawa Medical University Hospital had started in 1994 by Department of Ophthalmology. In 1999, 5 years later of the start of our telemedicine, the nation’s first “Telemedicine Center” had opened in our university hospital. In April 2000, the first telepathology had performed between our Telemedicine Center and Nayoro City Hospital. Until now, for 15 years, we had supported 688 cases of intraoperative pathological diagnosis to the 5 main hospital in the north Hokkaido or the east Hokkaido. Here I summarized our telepathological experiences for 15 years. Also I discussed the telepathological environment, especially health economics of telepathology, and the prospects for the future of telepathology.