Background and objective: One of the important and common applications of telemedicine is the diagnosis and treatment of skin diseases. However, teledermatology requires further commitments to provide standard services and appropriate electronic data transfer for reliable diagnostics to comply with technical standards and legal requirements. The present study aimed to determine the factors affecting the establishment of Teledermatology in the qualitative and quantitative sections. Methods: A mixed-method study (including quantitative and qualitative sections) was conducted in 2018. In the qualitative section, experts were selected by purposive sampling and the data were collected through 2 focus group discussions and 6 semi-structured interviews. The content of sessions and interviews were transcribed and then analyzed by the content analysis method. In the quantitative section, 384 participants were selected randomly. The data were collected using a researcher-made questionnaire whose validity and reliability were confirmed. Data analyses were performed in SPSS. Results: A total of 8 categories and 58 subcategories were extracted. The 8 categories of the factors affecting the establishment of teledermatology in Iran included service provider, service recipient, structural, technological, economic, policymaking, legal, and cultural. Cultural factors (3.95±0.77) and policymaking factors (3.22±0.84), respectively, had the highest and the lowest effects on the establishment of teledermatology in Iran. Conclusion: Factors affecting the establishment of Teledermatology are diverse and extensive, which the most effective factors were cultural factors, technological factors and factors related to service providers. These findings can help the policymakers and managers interested in the establishment of teledermatology in Iran.