Introduction: The teleconsultation service of Telehealth Network of Minas Gerais (TNMG), Brazil, has expanded gradually since its implementation in 2007. However, since 2013, there has been a decline in the number of teleconsultations. The objective of this study was to compare features of user and non-user cities and healthcare practitioners, in order to investigate the factors related to non-use of the TNMG teleconsultation service and assess users’ satisfaction with the service. Methods: Cities were classified as users and non-users according to the utilization of the service from June 2013 to May 2014; 160 healthcare practitioners were interviewed in each group. Among the user cities, 80 user healthcare practitioners (UHP-UC) and 80 non-user healthcare practitioners (NUHP-UC) were selected. Results: There was a significant difference in support and motivation by the local healthcare manager to use the teleconsultation service (67.5% in UHP-UC vs. 34.4% in HP-NUC, p ?0.0001; and 53.8 % in NUHP-UC vs. 34.4% in HP-NUC: p = 0.013), and with respect to training. (67.5% in UHP-UC vs. 45.8% in HP-NUC: p = 0,002). In multinomial logistic regression, (i) male gender, (ii) training and (iii) support and motivation from the local healthcare manager were independently associated with teleconsultation use. Conclusion: This study showed that training, and support and motivation from the local healthcare manager were the most important factors related to the teleconsultation use. This is an important finding that will assist in future development of approaches to increase the use and quality of teleconsultation services.