Telemedicine is drawing greater attention to improve the health care delivery. Video coding being an integral part of any real-time telemedicine system is used to deliver diagnostic video stream to remote physician. Realizing a video coding system customized for telemedicine, using the available technologies poses several challenges. In this paper, we have analyzed state-of-the-art video codecs for adoption in telemedicine customized video conferencing system under low-bandwidth and low-computational scenarios. The experimental results for the selected video codec implementations for medical videos reveal that the HEVC encoder achieves equivalent objective video quality when using approx. 60% bit rate on average. However, the gain in coding efficiency is at the expense of increased computational complexity, which could be dealt with by incorporating adaptive interpolation and selective quality enhancement techniques to achieve real-time performance. © 2015 IEEE.