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Trying to image pathology in both microscopic and macroscopic levels is a story that had begun in the early 17th century through the magic Lantern slides, or Scioption. Discovering the use of digital techniques has created a revolution in this story. The combination of digital pathology with the software and projection technologies has brought inevitable developments in education, research, communication, and practice in pathology in the past 50 years. Since the term “Telepathology” (TP) was introduced into the English literature by Weinstein in 1986, many other related denominations were used such as digital microscopy, digital pathology, teleconferencing, teleconsultation, tele microscopy, video microscopy, virtual microscopy, and whole slide imaging, among others. According to the American Telepathology Association (ATA), telepathology is defined as a form of communication between medical professionals that includes the transmission of pathology images and associated clinical information for the purpose of various clinical applications including but not limited to primary diagnoses, rapid cytology, intraoperative and second opinion consultations, ancillary studies, archival, and quality activities. There are many benefits in using TP, such as the possibility to access different pathology experts improving the quality of patient care, many operational gains such as to provide diagnosis at distance and also to promote research and education. Cytology-specific applications of TP (Telecitology-TC) are on rapid on-site evaluation (ROSE), screening-interpretation of Pap tests, and second opinion (teleconsultation). According to the American Telemedicine Association (ATA), there are different modes of TP/TC: static, video, robotic, and whole slide imaging (WSI). All these different modes have advantages and disadvantages and there is no one that hamper “one size fits all candidate” in the clinical practice. Thus, every laboratory has to decide the best suited system according to the main utilization of telepathology in their setting. The simplest mode of TP is the static because it just requires a microscope with a camera attached and a network to deliver the image to a remote individual place. Despite the low cost and low bandwidth requirements only limited portion of the specimen can be available to visualize which could cause a bias in the interpretation, especially in cytological samples. Therefore, this mode of TP is not suitable for ROSE or frozen sections and it is mostly used for educational purposes. In the other extreme of the spectrum, the mode “Whole slide imaging (WSI),” converts an entire slide into a digital image that allows seeing in a computer screen all slide instead of a chosen area. This mode requires high quality equipment (scanning system, monitor, and software), high internet bandwidth if the image need to be transmitted from a distant place and of course high capacity of storage. One of the problems of this system in cytology is the Z-axis focusing disability in high cellular specimens. This can be solved by imaging at different focal planes then stitch together; however, it will Conflıct of ınterest: No conflict of interest was disclosed. Department of Pathology subdivision of Cytopathology, Acibadem University, Kayısdagı cd. Ataşehir-Istanbul-TR, Turkey Department of Pathology subdivision of Cytopathology, Acibadem University, Kayısdagı cd. Ataşehir-Istanbul-TR, Turkey Laboratorie national de Sante, Dudelange, Luxembourg *Correspondence to: Fernando Schmitt, MD, Ph.D., FIAC, Laboratorie national de sant e, rue Louis Rech 1, L3555, Dudelange, Luxembourg. E-mail: [email protected] Received 12 November 2016; Revised 15 December 2016; Accepted 19 December 2016 DOI: 10.1002/dc.23663 Published online 31 January 2017 in Wiley Online Library (wileyonlinelibrary.com).