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Background The complexity of fetal medicine (FM) referrals that can be managed within obstetric units is dependent on the availability of specialist ultrasound expertise. Telemedicine can effectively transfer real-time ultrasound images via video‐conferencing. We report the successful introduction of a fetal ultrasound telemedicine service linking a specialist fetal medicine (FM) centre and a remote obstetric unit. Methods All women referred for FM consultation from the obstetric unit were seen via telemedicine, excluding cases where invasive testing or cardiac anomalies were anticipated. The image quality was rated following each consultation. Women's experiences and family costs were evaluated by a questionnaire completed following the first telemedicine appointment during the first phase of the project. Results Overall, 297 women had a telemedicine consultation during Phase 1 (pilot and evaluation) and Phase 2 (embedding and adoption) of the project, which covered a four year period. There were 154 new and 143 follow-up consultations. Thirty-four women completed questionnaires during the Phase 1 of the study. Travel to the telemedicine consultation took a median time of 20 minutes (4,150), in comparison to an estimated journey of 229.8 minutes (120,450) to the FM centre. Women were generally satisfied with the service and valued the opportunity to have a FM consultation locally. Conclusions We have demonstrated that a fetal ultrasound telemedicine service can be successfully introduced to provide FM ultrasound of sufficient quality to allow fetal diagnosis and specialist consultation with parents. Furthermore, the service is acceptable to parents, has shown a reduction in family costs and journey times.