Volumetric ultrasound (US) is a very promising development of medical US imaging. An under-exploited advantage of volumetric US is the mitigation of the strict probe positioning constrains necessary to acquire 2D scans, potentially allowing the decoupling of US image acquisition and diagnosis. However, today’s 3D US systems are large and beset by high power and cost requirements, making them only available in well-equipped hospitals. In this study, we propose the first telesonography-capable medical imaging system that supports up to 1024 channels, on par with the state of the art. As a first embodiment, we have implemented our design in a single development FPGA board of 26.7cm×14cm×0.16cm, with an estimated power consumption of 6.1 W. Moreover, we have equipped our platform with an automatic positioning module to help any operator defining the scan location, hence allowing for better remote diagnosis. Our design supports two types of data inputs: real-time via an optical connection and offline over Ethernet. The reconstructed images can be visualized on an HDMI screen. The estimated cost of the proposed prototype materials is less than 4000e.