Email between patients and physicians can be an effective means of communication and health care delivery, but concerns over security, privacy, fea- sibility, and legality prevail. This paper reviews the limited literature in this area, highlighting our current understanding of the prevalence of email in clinical prac- tice, patient attitudes toward email communication, and the impact of email communication on patient outcomes. While there is a paucity of data on the role, benefts, and risks of email communication, patients and physicians alike should consider secure email as a convenient tool for communication. Physicians require further guidelines on appropriate uses of email in clinical practice to best enhance patient autonomy, preserve patient confdentiality, and comply with current medico-legal standards.