Abstract: This study describes the design and development of a simple and low cost centralized telemedicine system in Palestine CTS. The proposed system overcomes existing isolation problems of Palestinian cities and villages and facilitates access to telemedicine services. The system servers communicate with remote locations through a dial-up technology, the internet, or using 128 kbps ISDN lines. The software protocol is capable to establish connection with more than one remote site, sort requests according to priority, identify the specialist through its database and respond automatically to the end user. A successful experiment shows that two communication links (the internet, wireless mobile phone) enables the transmission of a Chest-X Ray image from a rural clinic to the CTS. The transmission time and resolution were acceptable to physicians at both ends. The study is still in progress to test the remaining parts of the system.