An electronic image transfer system for computed tomographic images links the CT scanner in Altnagelvin Hospital, Londonderry with the regional neuroradiology department in the Royal Victoria Hospital, Belfast. In the first 13 months of operation, scans of 100 patients were transferred; 49 scans were taken in acute neurosurgical emergencies, and 51 were non-acute sent for a specialist neuroradiological opinion. Potentially hazardous inter-hospital transfer was avoided in 21 cases of acute neurosurgical emergency, and more efficient and appropriate referral was achieved in the cases whose scans had been sent for sent for radiological second opinion. We believe that the system has substantially improved the diagnosis and management of patients with neurosurgical problems in both hospitals.