Introduction. A prevalence of using telemedicine technologies in diagnostic radiology is global. Through telemedicine, significant optimization of resources is achieved, a personnel shortage is eliminated, and a quality and accessibility of medical care are improved. A purpose of this research is to assess a demand of state medical facilities of the city of Moscow for telemedicine consultations provided by expert doctors in diagnostic radiology for the period 2018-2020. Materials and methods. A retrospective analysis of data on the use of telemedicine technologies for expert consultations on the results of radiological studies conducted for the period from 2018 to 2020 was carried out. The data were compared with the results obtained in the 2017 study. [20]. Telemedicine consultations in Moscow diagnostic radiology services are carried out on the basis of the Unified Radiological Information Service of the Unified Medical Information and Analytical System of the City of Moscow (hereinafter referred to as URIS UMIAS). Interval dynamic analysis method was also used for in-depth evaluation. Analysis of the form "Information about a medical organization (annual)" (Order of Rosstat No. 13 dated January 14, 2013) allowed calculating a need for expert telemedicine consultations. Results. For the period from 2018 to 2020, experts of the Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Healthсare Department conducted 8,515 expert telemedicine consultations (hereinafter referred to as ETMC) on the request of radiologists of Moscow medical facilities. The overall demand for expert-level telemedicine consultations in Moscow for 2018-2020 averages 7.7 requests per day. The annual number of telemedicine consultations is 2,500-3,000. Compared to 2017, a number of ETMC per 1,000 CT exams decreased by 4 times, and a number of consultations per a CT scanner also decreased by 22%. A number of ETMC per 1,000 MRI exams decreased by 33% (by a third), a number of consultations per a MRI scanner increased by 6%. Discussion. To further improve the operation of diagnostic radiology services of the Moscow healthcare system, it is necessary to plan at least 2,800 ETMC per year. The estimated level of demand for ETMC in Moscow should be calculated at 1.2 telemedicine consultations per 1,000 CT exams and 6.0 telemedicine consultations per 1,000 MRI exams. It is required to organize additional education for radiologists on CT image visualization of the abdominal and thoracic cavities with contrast enhancement, as well as pelvic MRI. Conclusions. The main reasons for a decrease in ETMC were the following: a change in the structure of conducted studies due to Covid-19 related restructuring of medical facilities; a launch of the Moscow radiology reference center; implementation of artificial intelligence systems for processing medical images into a practical operation of the Moscow healthcare. A recorded consistent number of teleradiology consultations indicates a demand for the second opinion teleradiology model in the capital's healthcare.