Video consultations have seen increasing use in nephrology since the COVID-19 pandemic with an aim to address constraints in F2F outpatient capacity and also patients’ concerns around risks of infection when attending healthcare facilities. Nephrologists have learned through experience to use video consultations for providing routine follow up and also for ad hoc triage of unwell patients. Advantages of video consultations include convenience, cost savings through avoiding clinic overheads, and reducing the carbon footprint of care. The last is increasingly relevant as nephrologists consider climate change and its implications. Video consultations are not a panacea to overcome challenges in nephrology and risks also exist for example when it comes to redesigning pathways and maintaining access to F2F assessments when required. It is equally important to consider practical aspects such as reimbursement, prescribing, and documentation. Some clinicians may wish to carry out video consultations from home to save time spent commuting but this, too, requires careful thought. Another consideration is the digital divide and support should be provided for patients who are less IT literate or who have no access to the digital world. Patients with special needs such as those with visual or hearing impairment and those with language issues also require consideration. We view video consultations as a developing and growing part of the portfolio of renal care. We see their main role in providing routine follow up to stable and IT literate outpatients, particularly where there is provider continuity and where care is provided across a large geographical area.