Telemedicine and telepharmacy play an important role in expanding access to pharmaceutical services, particularly in rural areas that face shortages of pharmacy personnel and healthcare facilities. However, comparative syntheses focusing on the differences in telemedicine implementation between rural and urban communities in Indonesia remain limited. This literature review aims to analyze the role of telemedicine in improving pharmaceutical service accessibility and to compare its implementation between rural and urban communities. The review was conducted systematically using PubMed and Google Scholar databases with the keywords “telemedicine, rural and urban telepharmacy, and telemedicine accessibility.” From 540 identified articles, 11 articles were selected based on inclusion and exclusion criteria. The findings indicate that telemedicine facilitates medication consultations, e-prescriptions, patient education, and chronic disease monitoring through various digital platforms. Several services, such as WhatsApp, Halodoc, and other digital health applications, have supported the improvement of pharmaceutical service accessibility. A significant gap was identified between telemedicine implementation in urban and rural areas, where urban communities demonstrated more optimal implementation due to better technological infrastructure and digital literacy, while rural communities continued to face limitations related to internet connectivity, healthcare facilities, and technology adoption. This literature review concludes that telemedicine significantly contributes to improving efficiency and promoting equitable access to pharmaceutical services between rural and urban communities.