Gastroenterology, as a sub-speciality in medicine, has been widely developed across the Pacific Nations during the last decade as a result of ‘hub’ training in Suva, Fiji. Professional isolation for trained pacific gastroenterologists has remained an issue due to the high cost of travel, limited in-country workforce, and recently COVID-19 border closures. Whereas Telehealth solutions have been used for decades across many Pacific Island Nations as a means to improve the clinical outcomes in Pacific Island patients, only recently has this technology been cleverly adopted in fostering education and skill development in Pacific gastroenterology. In this paper, we describe the evolution of these various methods and discuss their use and adaptation in various clinical situations. Herein we consider the future of telehealth programs and the potential for positive impact on Pacific Island healthcare.