Retinopathy of prematurity (ROP) remains a leading cause of childhood blindness worldwide, although the strategies have improved greatly. Current disease management systems have many limitations. Telemedicine is an emerging technology that has the potential to improve the accessibility and quality of ROP management. However, many challenges remain. In this article, we reviewed the current literature on applications of telemedicine for ROP, and summarized its necessity, feasibility, advantages and challenges for use. We particularly address the diagnostic accurgcy and reliability as well as the cost-effectiveness of telemedicine for ROP. We predict a promising future for implementing this system on mainland China as well as the rest of the world.