This narrative review delves into the transformative role of telemedicine in the realm of surgical decision-making. Telemedicine, a significant innovation in healthcare services, leverages electronic information and communication technologies to provide healthcare services when distance separates the participants. It addresses the challenges of increased healthcare demands, an aging population, and budget constraints. Telemedicine technologies are employed for pre- and postoperative consultations, monitoring, and international surgical teleconferencing and education. They enhance healthcare access, particularly in remote areas, and facilitate knowledge sharing among healthcare professionals. The review also provides a historical context and discusses the technological advancements in telemedicine, including the rise of digital health technologies and the integration of artificial intelligence and machine learning in healthcare. It delves into the details of telemedicine technologies such as telesurgery, telerobotics, telepathology, teleimaging, remote patient monitoring, and virtual and augmented reality. Despite the numerous benefits, the implementation of telemedicine is often hindered by various complex and diverse ethical and legal concerns, including privacy and data security. The review highlights the need for further evidence on health outcomes and cost savings, bridging the digital divide, and enacting policies to support telemedicine reimbursement. It also emphasizes the need for incorporating telemedicine modules in medical education. It recommends that policy-making bodies consider utilizing telemedicine to address healthcare coverage gaps, particularly in rural areas.