OBJECTIVES At the global level the large deployment of telemedicine raises needs for cost-effectiveness evaluations. The objective of this literature review is to explore to what extend telemedicine innovations that were implemented in many countries were cost-effective. Specifically, we explore whether the model used to evaluate the cost-effectiveness can be adapted to the evaluation of telemedicine technologies. So, what answers can a review of the international literature relating to the medico-economic evaluation of telemedicine provide? METHODS Following analytical reading of 286 articles published between 2000 and 2013, 74 studies that implemented economic evaluation of telemedicine are analysed. Three axis of analysis are considered: the act concerned by the telemedicine intervention, the medical speciality, the economic evaluation method implemented. RESULTS The descriptive analysis showed significant heterogeneity in studies characteristics: economic analysis method, telemedicine applications, medical specialities, and organisational practices. The qualitative analysis underlines that most studies face methodological issues and provide reduced evidence of the economic impact of the telemedicine interventions. The telemedicine technologies are too individualised (by the context and the organisation) to be evaluated using the standards of cost-effectiveness analysis.  CONCLUSIONS This literature review did not allow proposing a classification for telemedicine practices identified as efficient, depending on the strategies compared, field of application or speciality, types of telemedicine or an organisation of care model. Despite all this, one focus can be the management of chronic diseases that remains a central topic at the international level. The increase in the number of medical specialities or fields of application concerned with telemedicine and the increased volume of activity necessitate the dissemination of methodological recommendations to promote the coherent development of economic evaluations. Our literature review shows that there is need to develop innovative methods to assess the cost- effectiveness of telemedicine technologies.