A mobile telemedicine unit (MTU) was constructed for emergency and screening purposes in north-west Russia. The MTU included facilities for endoscopy, electrocardiography and digital photography. Data transmission was by ordinary telephone line. Between July and December 1999, the MTU was used in 48 incidents, involving 44 patients. The MTU was used to conduct 22 teleradiology examinations and 20 electrocardiograms were transmitted; in 10 cases still images of patients were transmitted and three consultations included tele-electroencephalography. Despite poor-quality analogue telephone lines, the MTU may prove useful in north-west Russia. Following the pilot study, the local Russian health administration stated that the MTU should always be included on emergency trips to the districts.