The integration of telecommunications and information technology in healthcare is referred to as telemedicine. While there may be numerous definitions, its application in disaster response has been well documented. This chapter is meant to introduce the reader to what has been done historically and how this historical context will help build the foundation for a Multinational Telemedicine System (MnTS). The application of telemedicine in disaster is neither new nor novel. With the advent of satellite communications and the introduction of real-time communications, other than telephony, medical personnel could interact with first responders and populations impacted by disasters. From the early uses of telemedicine in the aftermath of an earthquake in Armenia to the development of the MnTS, an historical summary is provided.