Background Potential users’ preferences for telemedicine services directed to cardio-vascular diseases are investigated applying a discrete choice experiment (DCE). Given the potential of telemedicine to minimize costs without reducing overall efficiency, assessing preferences for these types of services represents a priority for policy makers. This is especially true for those pathologies that absorb a relatively high quota of total health expenditure. The empirical setting is Sardinia (Italy) because of its insularity and the underdeveloped internal transport network. Telemedicine is likely to mitigate distance between healthcare providers and final users. Methods A survey conducted between February and May 2013 was administered to a selected Sardinian population older than 18 (potential users) through face-to-face interviews. A discrete choice experiment was implemented and four attributes (i.e. scanning mode, location, waiting list and cost) assess in what measure these influence potential users’ utility by using a random parameter modelling with heterogeneity (RPH). Results The empirical findings, based on 2000 interviews, highlight that potential users are not very open to the application of telemedicine services in cardiology, mostly preferring the intromoenia (visit at the hospital) and private system. Besides, remarkable individual heterogeneity has been found. Conclusions Potential users see the implementation of new technologies in healthcare with a certain caution. However, the relatively higher preferences towards services provided at their own municipality suggests that there is ground to explore further the implementation of telemedicine services through the family doctor and local pharmacy.