ObjectivesTo obtain an overview of teleradiology usage within Europe, to evaluate the current opinion and future vision about this technique.MethodsA web-based survey targeted at active radiologists throughout Europe.ResultsA total of 368 radiology professionals participated in the survey. Among them 65 % currently use teleradiology. The main usages are in-house image distribution (71 %) and on-call readings from home (44 %). The major advantages are improved collaboration with other radiologists (46 %) and efficient distribution of workload (38 %). Outsourcing is performed by 35 % of the participants, among them 68 % use commercial services. The major advantages of outsourcing are availability of second opinions (82 %) and additional capacity for on-call services (71 %). The major disadvantages are insufficient integration of patient history and priors (69 %), and limited communication with clinicians (68 %). The majority expressed a positive opinion regarding the future of teleradiology (80 %) predicting a growing importance (46 %). Opportunities ought to be found in emergency reading services, flexible support of small practices and in collaborative platforms.ConclusionsA wide usage of teleradiology throughout Europe is perceived; however usage of commercial services is relatively limited. Regarding cross-border services, there is a great demand for a focused Pan-European legislation, an adapted price regulation and a quality assurance framework.Main Messages• A wide variety of teleradiology applications exist in Europe• Implementation mainly occurs in countries with a high concentration of networked PACS• Usage of commercial teleradiology services in Europe is relatively limited• Language is an unsolved issue and limiting factor for further deployment of services• There is a demand for a Pan-European legislation, price regulation and quality assurance framework