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This study uses qualitative methods to assess the experiences of psychodynamic psychotherapists and clients who engage in video psychodynamic psychotherapy. All interviews were digitally recorded for transcription; transcripts were analyzed using thematic analysis to identify themes. Convenience sampling, the intentional sampling of a population with firsthand knowledge of a phenomenon to collect ample detailed information, was conducted. Therapists’ and clients’ experiences engaging in video psychodynamic psychotherapy can be described in relation to the following broad categories: setting, missing information, confidentiality, the choice to attend online analysis as an indication of personal issues, the generation of unique therapeutic content in the online context, the convenience and availability of online analysis, and legal and ethical issues. The results provide empirical evidence for the development of clinical and ethical guidelines and standards for future video psychodynamic psychotherapy. Understanding the clinical and ethical challenges of video psychodynamic psychotherapy can facilitate the generation of clinical and research guidelines to address those challenges.