Telepsychiatry has emerged as a promising method for delivering mental health services to remote or underserved populations worldwide, including those with Borderline Personality Disorder (BPD). In South Africa, where access to specialized psychiatric care is limited, telepsychiatry may offer a viable solution. However, little empirical research exists to evaluate its effectiveness in this context. Qualitative data were collected through semi-structured interviews with healthcare professionals and focus groups with BPD patients from six major hospitals across the country. Data analysis focused on thematic content. Findings indicate that while telepsychiatry was generally well-received by both providers and patients, significant technical issues often disrupted service continuity. Patient engagement varied; some found it more convenient than in-person sessions, but others preferred face-to-face interactions for therapeutic rapport. Despite initial enthusiasm, the study highlights substantial barriers to widespread telepsychiatry adoption for BPD treatment in South African hospitals, suggesting further research and policy development are necessary before broader implementation. Future studies should explore alternative solutions or hybrid models that leverage telepsychiatry while mitigating technical limitations. Policy makers should also consider regulatory frameworks to support the integration of these services into existing healthcare systems. telepsychiatry, Borderline Personality Disorder (BPD), South Africa, qualitative study