The invention discloses a real-time telemedicine consultation system comprising a first consultation terminal, a second consultation terminal, a third consultation terminal, an information acquisition terminal and a data processing center; the first consultation terminal is an expert consultation terminal; the second consultation terminal is an attending doctor consultation terminal; the first consultation terminal and the second consultation terminal both comprise input modules, display modules, instant video communication modules, voice recording modules and storage modules; the third consultation terminal is a patient consultation terminal comprising an input module, a display module, an instant video communication module, a voice recording module and a storage module; the data processing center is used for receiving and storing consultation expert personal information, consultation expert recording consultation main points information, consultation expert speaking information, attending doctor personal information, attending doctor recording consultation main point information, attending doctor speaking information, patient personal information and patient speaking information sent by each consultation terminal. By means of the system, the whole consultation process can be automatically recorded which is convenient for query and provides effective reference for later diagnosis and treatment.