The Internet has established itself as an affordable, extremely viable and ubiquitous communications network that can be easily accessed from virtually any point in the world. This makes it ideally suited for medical image communications. Issues regarding security and confidentiality of information on the Internet, however, need to be addressed for both occasional, individual users and consistent enterprise-wide users. In addition, the limited bandwidth of most Internet connections must be factored into the development of a realistic usermodel and resulting protocol. Open architecture issues must also be considered so that images can be communicated to recipients who do not have similar programs. Further, application-specific software is required to integrate image acquisition, encryption and transmission into a single, streamlined process. Using Photomailer™ software provided by PhysiTel Inc., the authors investigated the use of sending secured still images over the Internet. The scope of their investigation covered the use of the Internet for communicating images for consultation, referral, mentoring and education. Photomailer™ software was used at several local and remote sites. The program was used for both sending and receiving images. It was also used for sending images to recipients who did not have Photomailer ™, but instead relied on conventional email programs. The results of the investigation demonstrated that using products such as Photomailer™, images could be quickly and easily communicated from one location to another via the Internet. In addition, the investigators were able to retrieve images off of their existing email accounts, thereby providing greater flexibility and convenience than other systems which require scheduled transmission of information on dedicated systems. We conclude that Photomailer™ and similar products may provide a significant benefit and improve communications among colleagues, providing an inexpensive means of sending secured images on the Internet.