In this paper, a teleconference system for medical image processing and orthopedic surgical simulation is presented. The system has been designed to integrate main functions for surgical teleconferencing using 3-D medical images for the user's convenience. The developed system, Teleconference System for Orthopedic Surgical Simulation (TOSS), includes three important components: the conference manager, the database manager and the surgical simulator. The conference manager controls conference flows and allows users to share workspace. The database manager maintains the conference database for patient data and conference data. The surgical simulator performs medical image processing for visualization and simulation. We find that the developed system can provide excellent support for cooperation in certain scenarios.