Tele-ultrasonography is an application of telemedicine to diagnostic ultrasonography, which currently uses multiple systems, more or less complex, in order to acquire ultrasound scans of quality sufficient to be interpreted at a distance by an expert, which is requested to make a diagnosis or provide a second opinion. One of the most recent areas of application of new technologies is tele-ultrasonography with wireless systems, in order to improve the portability of the equipment and to simplify the remote transmission of images, with a significant reduction in costs. Recently, the TOCOMAT system of prenatal telemedicine, active since 1998 in Campania, has been updated with an application of wireless tele-ultrasonography for remote ultrasound monitoring of patients at risk living in rural or decentralized areas. The system is based on a next-generation portable ultrasound scanner able to transfer the images to a handheld computer system, which then forward them to the Operation Centre by connecting to a wireless internet network. The results obtained during the first six months of employment with the new system show that it is technically easy to apply and well accepted by physicians and patients, and can help to reduce the gap in the level of health care between the peripheral areas and the center.