Remote triage, which can be delivered via telephone, email or video conference, has been linked to potential adverse events. This systematic review evaluated the effects of remote triage systems on healthcare utilization and patient safety outcomes. Of the eight studies identified, three cluster RCTs found high rates of call resolution in local, practice-based triage services compared with regional or national services. Two cluster trials examined the effects of remote triage on mortality, hospitalizations and ED visits; neither reported statistically significant differences indicating increased risk for these patient safety outcomes.