OBJECTIVES: Many cats do not see a veterinarian on an annual basis, and their caregivers face many barriers to accessing veterinary care. A potential solution to overcome some of these barriers is video telemedicine. Thus, the aim of this study was to understand companion cat caregivers perceptions of using veterinary video telemedicine with their cats. METHODS: An online quantitative questionnaire was used to survey US cat caregivers on their experiences of and attitudes to using video telemedicine with their cats. Participants were required to reside in the USA, be the primary caregiver of at least one cat and be aged 18 years or older. RESULTS: The majority (97.3%) of the 1254 respondents indicated they had never used a video telemedicine appointment with their cat(s) before; however, most (85.7%) indicated they were very or somewhat interested in using video telemedicine with their cat. Overall, caregivers perceived video telemedicine visits as less stressful for themselves (P <0.0002) and their cats (P <0.0001), and as increasing their access to veterinary care (P <0.0001) compared with in-clinic visits. Participants also indicated they would prefer a video telemedicine appointment over an in-clinic appointment for most cat behavioral concerns but preferred in-clinic appointments for most health concerns. Most respondents (51.3%) indicated they would be willing to pay a little less for a telemedicine appointment than an in-clinic visit. CONCLUSIONS AND RELEVANCE: Cat caregivers represent an important population that could benefit from the implementation of video telemedicine into veterinary care. Our results suggest many US cat caregivers indicate an interest and willingness to pay for video telemedicine visits to increase their access to veterinary care and reduce stress associated with veterinary visits for both themselves and their cats. Caregivers showed more interest in using video telemedicine for behavioral concerns than health concerns.