BACKGROUND Telemedicine is a medical practice of assisting remote patients and it has great potential in developing countries like Pakistan. Telemedicine solves the logistical barriers, deliver good support to weak health systems and unite worldwide networks of healthcare personals. Because of high implementation costs, yet it is not possible to adopt telehealth systems for low and middle-income nations. OBJECTIVE In this systematic review, we aim to present an update revision of region-based telemedical services in Pakistan. METHODS Libraries such as PubMed (Medline), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Scopus (EMBASE) and Google Scholar were used for document search. Newcastle Ottawa Scale (NOS) is adopted to conduct study quality. Majority of the studies (n-8) included in the review were of high quality as assessed through the Newcastle Ottawa scale. Selected study characteristics further analyzed based on different parameters such as publication year, sample size, study design, methods, motivation and outcomes. RESULTS Search produced 955 articles and 11 items were ultimately selected to conduct the review. These studies further characterized as region-based telemedicine implementation. Out of 11, eight studies were conducted in the urban region and three studies were conducted in the rural areas of Pakistan. Majority of studies produced evidence on telehealth interventions by smartphone services like SMS, apps and web-based telemedicine. CONCLUSIONS Telehealth interventions like mHealth, eHealth, telemedicine, and telepharmacy are starting to evaluate for the last two decades but certainly needs to become an integral part of Pakistan's current health infrastructure.