Access to quality cancer care is often unavailable not only in low- and middle-income countries but also in rural or remote areas of high-income countries. Teleoncology (oncology applications of medical telecommunications, including pathology, radiology, and other related disciplines) has the potential to enhance both access to and the quality of clinical cancer care as well as education and training. Its implementation in the developing world requires an approach tailored to priorities, resources, and needs. We believe that teleoncology can best achieve its proposed goals through programmatic, consistent, and long-term application. Here we review teleoncology initiatives that have the potential to decrease cancer care inequality between resource-poor and resource-rich institutions and offer guidelines for the development of teleoncology programs in low- and middle-income countries.