We describe the telemedicine experience of an Italian ALS tertiary Center during COVID-19 pandemic . A total of 144 visits were scheduled between 6th March and 6th April 2020 . These mostly consisted of neurological or psychological visits (139 , 96.5 %). One hundred thirty-nine (96.5 %) visits were performed as telemedicine and mostly via phone call (112 , 80.6 %). Three (2.1 %) visits were considered as urgent and maintained as outpatient care . Additionally, patients were still able to telephone, being put through directly to their neurologists . Many requests of contact were addressed at getting information about the scheduled visits or examinations (45 , 43.3 %). Globally, patients and caregivers were satisfied with the telemedicine service . However, the majority (85 , 65.9 %) would prefer a face-to-face visit . In conclusion, telemedicine could be considered a good complement to face-to-face care, even after social restrictions have been eased.