Children are at high risk for medication errors in emergency departments (EDs). Physician prescribing has been implicated as the most common source of these errors. This retrospective study found that telemedicine consultations for pediatric critical care were associated with fewer physician-related medication errors among seriously ill children in rural EDs. Telemedicine consultations seemed to reduce medication errors more than traditional telephone consultations. Telemedicine may prove to be an important tool for improving the care of rural patients across many different scenarios.