Background: Cryptorchidism is the most common referral to our paediatric surgical telehealth service. There is a paucity of literature on this condition in a telehealth context. We wished to determine the accuracy of telehealth in the diagnosis of cryptorchidism, and to examine for any predictors that may increase diagnostic confidence. Methods: Retrospective analysis of a consecutive cohort from November 2009 (start of service) to December 31st 2021. Data from telehealth were compared against eventual surgical outcomes. Results: There were 387 consecutive patients seen, resulting in 335 bookings for orchidopexy. 69/327 patients presenting for operation did not have an orchidopexy performed. Operations did not proceed as booked for 37% of children. Referrals for bilateral cryptorchidism were more likely to be normal on face to face review. The average round-trip distance for families from home to hospital, and back, was 948km. Conclusions: Telehealth is not an accurate method for assessing cryptorchidism. Operations were cancelled for 1 in 5 children, and altered for 3 in 8. Travel distances for families were significant. The inaccuracy of telehealth for assessing cryptorchidism must balance inconvenience for families against disruption to elective operating lists.