With the expanding role of tele-ICUs, it is imperative to integrate critical care ultrasonography into the patient care model. Using our tele-ICU system, we conducted a pilot study to determine the feasibility of real-time interpretation of PCUS images acquired at the bedside via the tele-ICU. A total of 52 PCUS examinations (18 lung, 18 cardiac, and 16 lower extremity compression [le-CUS] studies) were performed by a bedside intensivist. Independent image interpretation was performed by the bedside intensivist and the tele-intensivist who interpreted the images via the video monitors zoomed in to the ultrasound screen. Six thoracic, 10 cardiac, and 10 le-CUS studies were read as normal. Twelve thoracic, eight cardiac, and six le-CUS studies revealed a pathologic finding (eg, B-lines, lung consolidation, pleural effusions, pericardial effusions, reduced left ventricular function with segmental wall motion abnormalities, DVT). There was 100% concordance in the image interpretation by the bedside intensivist and the tele-ICU physician. When the recorded video clips were reviewed by the third blinded intensivist, concordance regarding study results was also 100%.