Aim: Telehealth is a useful method of providing specialist consultation to a geographically diverse population. Canadian studies of telehealth for paediatric surgery demonstrate good accuracy, but have low numbers of cryptorchid patients in their cohorts. Our aim was to confirm Canadian studies for our cohort and to assess accuracy regarding cryptorchidism. Methods: We conducted a cohort study of patients seen via paediatric surgical telehealth over a 12-month period, to determine accuracy of telediagnosis with respect to face-to-face diagnosis and plan. Results: A total of 183 children had 224 videoconferences, resulting in 74 surgical bookings. There was high diagnostic concordance, except for undescended testes. One discharged patient, and two patients booked for review, have subsequently required an orchidopexy (false negatives). Of 15 patients booked for surgery, three did not require an operation (false positives). Other patients had their procedures upgraded (from open to laparoscopic) or downgraded (from laparoscopic to open) due to inaccuracies in far-end assessment. Conclusion: Telehealth for paediatric surgery is accurate for most conditions seen, but for cryptorchidism there are significant concerns.