Disasters occur when we least expect and when we are often not prepared. There are many differences across the globe on the ability to respond and these differences are based almost entirely on socioeconomic conditions in the affected society or region. A highly developed nation has a lower risk of catastrophic destruction and death as compared to a developing nation. Nevertheless, healthcare in the immediate and post or chronic phase of a disaster is vital to recovery, stability and security. Over the past 5–6 decades, telemedicine has been integrated successfully in disasters and has been shown to be effective. This chapter summarizes this previous work and highlights the NATO-developed Multinational Telemedicine Systems for Disasters. It lays out the award winning strategy of Initiate, Build, Operate, and Transfer, developed by the International Virtual e-Hospital and implemented across several Balkans countries. It provides a summary of the challenges telemedicine faces in the integration of healthcare. The chapter closes out with a summary of the many resources that are available for using telemedicine in disasters.