The study, Leveraging AI-Driven Telemedicine for Efficient Healthcare Delivery in Anambra State, explored the impact of AI-Driven Telemedicine on accessibility, challenges faced during implementation, strategies for successful adoption, and the development of a tailored decision support interface. The objectives sought to; predict the impacts of AI- driven telemedicine solutions on healthcare outcomes and patient satisfaction, evaluate the possible challenges in the implementation of the AI-based telemedicine solutions, develop strategies for easy implementation and sustenance of the AI-based telemedicine, and provide the features and functionalities that would be incorporated into the AI-driven decision support interface that would optimize healthcare accessibility and efficiency in the state. The study employed a mixed-methods research approach, including surveys, interviews, and a comprehensive review of existing literature. The findings showed that AI-driven telemedicine solutions will have positive and significant impact on healthcare outcomes and patient satisfaction (tstatistic, 3.535 > tcritical, 2.571). With the result, tstatistic, 8.875 > tcritical, 2.306, the study indicated that the implementation of AI-based telemedicine solutions in Anambra State would be faced with some challenges such as funds, limited internet connectivity, ethical concerns, regulatory compliance, etc. However, it highlighted some strategies that need to be developed to facilitate a seamless implementation and sustenance of the AI-based telemedicine (tstatistic, 3.646 > tcritical, 3.182). The study also identified some features and functionalities that would be incorporated into an AI- driven decision support interface to optimize healthcare accessibility and efficiency in Anambra State (tstatistic, 14.909 > tcritical, 2.262). The study concluded that addressing the identified challenges and leveraging the potentials presented by AI-based telemedicine will require a concerted effort from the government, healthcare providers, policymakers, telecoms providers, and the academic community. Therefore, it was recommended that the government and relevant stakeholders should prioritize infrastructure development, particularly in the areas of power supply and internet connectivity, while the policymakers should collaborate with medical experts to develop and implement regulations, policies, and strategies that promote the adoption of AI-based telemedicine.