In a rural district of South Africa using teleradiology, challenges in communication are heightened because of end users being geographically dispersed from each other. End users, namely radiographers, radiologists, and referring clinicians are key players in the efficient functioning of teleradiology systems and must collaborate to deliver a radiological service. This study aims to present how the interaction between these health professionals in a rural district of South Africa influences the teleradiology service delivered and provides recommendations on how interprofessional collaboration between them can be enhanced. A qualitative study with an exploratory, descriptive approach was adopted. Focus group interviews were conducted with the onsite end users, namely the radiographer and referring clinicians on different days. A separate interview was conducted with the radiologist at the remote reporting site. Qualitative content analysis was used to analyze the transcribed data. There are significant strains in the interprofessional relationships between all end users as a result of miscommunication. This stems from failure to implement and revise standard teleradiology guidelines, which creates a gap in establishing well-defined responsibilities. Second, end users at the teleradiology site lack support from the remote radiology service provider, who must provide guidance and educational support. This translates in the rural community receiving a suboptimal radiology service. Telecommunication is not limited to telephone lines but is largely influenced by the quality of engagement between end users and the use of additional support structures, such as standard guidelines and video conferencing, to facilitate effective communication.