Past traditions and prejudices may have precluded many analysts from openly considering the use of telephone analysis as a viable treatment option. However, at times psychoanalysis by telephone may represent the best treatment available for a particular patient. Use of the telephone in clinical practice evokes complex feelings and raises a number of important issues for both patient and analyst. A case of telephone analysis is presented to illustrate the poignancy of initial telephone contact, issues associated with the decision to do psychoanalysis by telephone, some of the paradoxes and complexities of telephone work itself, and the termination process. Initial resistances by both patient and analyst are discussed, and modification of technique and its applicability to psychoanalysis in general are examined. Indicators for telephone analysis are considered.