There is a need to better understand the function of postoperative care via telemedicine (TM). Researchers assessed patient satisfaction and outcomes of postoperative face-to-face (F2F) versus TM visits for adult ambulatory urological procedures in an urban academic center. This was a prospective, randomized, controlled experiment. Patients undergoing ambulatory endoscopic procedures or open surgery were randomly 1:1 to a postoperative F2F or TM visit at the surgery. After the appointment, a telephone survey rating satisfaction was administered. The primary result was patient satisfaction; secondary outcomes were time and cost savings and 30-day safety outcomes. A total of 197 individuals were approached; 165 (83%) consented and were randomized—76 (45%) to F2F and 89 (54%) to TM cohorts. There were no significant variations in baseline demographics between the groups. Both groups were equally satisfied with their postoperative visits (F2F 98.6% vs. TM 94.1%, P=0.28) and judged their visit to be an acceptable kind of health care (F2F 100% vs. TM 92.7%, P=0.06). The TM cohort saved a considerable amount of time (TM 66.2% spent <15 minutes vs F2F 43.1% spent 1–2 hours, P<0.0001) and money (44.1% TM saved $5–$25 vs 43.1% F2F spent $5–$25, P=0.041) connected with travel. There were no significant variations in 30-day safety results between the cohorts. TM for postoperative visits following ambulatory adult urological surgery saves patients time and money without compromising satisfaction or safety. TM should be offered as an alternative to F2F for routine postoperative treatment for some ambulatory urological operations.