Study purpose This study aims to examine patient preferences for teleradiology services and remote image interpretation. In this context, this study aims to address the following research questions: (i) How do patients perceive teleradiology services, focusing specifically on comfort, quality of care and satisfaction, communication and information, and accessibility and ease of use; (ii) How do patient demographics (age, gender, urban vs. rural residence) influence the perceptions on teleradiology services? Methods A cross-sectional survey design is adopted in this study. The survey comprises five sections targeting demographic information, comfort, and preferences regarding remote image interpretation, perceived quality of care and satisfaction, communication and information clarity, and accessibility and technology aspects using five-point Likert scale ratings. A total of 406 patients (209 males and 197 females; 170 urban residents; 174 semi-urban residents, and 62 rural residents) using teleradiology services participated in the study. Results Participants reported high satisfaction with remote image interpretation (3.78 ± 1.19), quality of care (3.31 ± 1.19), understanding (3.84 ± 1.43), and user-friendliness (3.67 ± 1.29). Key issues were technical problems (3.81 ± 1.35), feedback difficulties (3.19 ± 1.58), privacy concerns (2.43 ± 1.46), and low awareness (2.37 ± 1.12). Urban participants scored significantly better in comfort, preferences, and communication than those from semi-urban and rural areas. Conclusion Teleradiology design and implementation should be optimized to align with patient preferences and enhance overall satisfaction.