Telepsychiatry, thanks to the continuous advance of technologies, is an area with excellent prospects to become an effective tool for assistance in psychiatry. Many studies evaluated the effectiveness of telepsychiatry in different psychiatric disorders like anxiety disorders, psychotic disorders and depression. Results showed that telepsychiatry seems to be promising in anxiety and depressive disorders, especially in the maintenance phase, and also for psychotic disorders, especially for these cases with a poor compliance. We reviewed the literature to evaluate the feasibility of telepsychiatry in Italy in terms of satisfaction, costs and cultural acceptability and considering ethical and legal aspects. In Italy the development of telemedicine still presents a high level of fragmentation. A potential integration of these new types of services with the health care system is a very challenging task and poses many legal and ethical challenges. Therefore the creation of legal instruments and formal professional ethical guidelines are needed.