E-mail has become a commonplace 'procedure' in medical practice because it is efficient and inexpensive. However, there are potential misuses and abuses of this form of written communication, with clinical and ethical implications. Common uses of e-mail in paediatics include general communication with colleagues in a professional setting; electronic formal consultation, in which patient confidentiality is paramount; electronic 'curbside' consultation, which may be perceived as a formal consultation electronic discussion groups, which lack peer review; communication with currect patients or their parents, which should be limited to simple, nonurgent issues; and communication with individuals seeking medical advice who are not patients, which is generally ill-advised. The present practice point offers a few practical suggestions including e-mail etiquette, security measures to ensure confidentiality, development of an e-mail policy for patients and parents, and separation of personal from professional e-mail.