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Introduction: The planet is facing a substantial crisis of global warming from the burning of fossil fuels. The global healthcare system contributes to 4.4 % of global emissions part of which can be attributed to patient travel. Telemedicine has the opportunity to provide care while obviating the need for travel. We hypothesized that the use of pediatric telemedicine will decrease carbon emissions. Methods: We performed a review of a prospective electronic medical record system of all children that presented to an outpatient children's hospital center from August 2019 through February 2022. The primary outcome was the number of telemedicine visits that occurred per month during the time period. The home zip code for each patient was included and used to calculated the median round trip distance to travel to the outpatient clinic. The EPA greenhouse gas equivalents calculator was utilized to convert car emissions data to carbon dioxide (CO2) emissions data. Results: Over the investigation period, there were 20,845 pediatric telemedicine visits. The travel distance that was eliminated was 1,562,716 miles (roundtrip). Using an estimate of 22.5 miles per gallon, this represents a savings of 69,454 gallons of fuel, which translates to 618 metric tonnes of CO2 saved. Conclusion: In children, telemedicine can decrease time away from school, work for parents, need for childcare, as well as the cost and time for travel. Pediatric telemedicine use can benefit the environment through the substantial reduction of carbon dioxide emissions.