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Objective: This study aimed to comparatively analyze selected countries’ telepharmacy guidelines and propose directions for improving domestic guidelines. Methods: This was a multi-country comparative study analyzing 8 guidelines from 7 countries including South Korea, Australia, Canada, Singapore, Spain, UK and US. The analytical framework, based on WHO and International Pharmaceutical Federation reports, comprised eight core items and was applied to analyze the guidelines. Guidelines’ completeness was assessed using a three-tiered scale by two independent researchers. Results: Guidelines generally defined telepharmacy as qualified pharmacists using Information and Communication Technology for remote medication supervision and is emphasized as a supplement to face-to-face services. The primary difference between the Korean and international systems lies in the strictness versus maturity of regulations. International guidelines, often produced by professional organizations, ensure service quality while allowing broader pharmacist autonomy. Five countries, except South Korea and the UK, offered expanded services such as Comprehensive Medication Management (USA) and chronic disease management (Singapore). Korea showed the strictest procedural controls (e.g., volume limits) but lacked explicit standards for service quality or quality management. In contrast, Australia, Canada, Singapore, and the USA required tele-counseling quality to be equivalent to or higher than face-to-face care. Among the countries analyzed, only Korea specified details of the service reimbursement system. Conclusion: To enhance domestic service quality, it is necessary to establish an institutional framework for standardizing counseling criteria, broadening specialized services through social consensus, and systematizing education to strengthen pharmacists' digital competencies, along with the active and voluntary participation of pharmacist associations.